Assessment of Relationship Between Nutritional Status and Handgrip Strength in Hemodialysis Patients
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Keywords

hemodialysis
nutritional status
anthropometric measurements
biochemical parameters
muscle strength

Abstract

In hemodialysis patients, the prevalence of malnutrition is high; a decrease in muscle strength is observed.

 The objective of the research was to evaluate the nutritional status of hemodialysis patients and the relationship between the nutritional status and muscle strength.

Materials and Methods. Sixty hemodialysis patients (38 males, 22 females) were chosen from among volunteers. Food consumption, biochemical values, anthropometric measurements, body composition, physical activity status, subjective global assessment, and handgrip strength in individuals were examined.

Results. According to subjective global assessment, 73.3% of patients were well-nourished, 26.7% of patients were moderately malnourished. In male patients, a moderate positive correlation was determined between handgrip strength and lean body mass (r=0.359, p<0.05), albumin level (r=0.408, p<0.05), energy intake (r=0.437, p<0.05), protein intake (r=0.345, p<0.05). In female patients, a moderate positive correlation was determined between handgrip strength and body weight (r=0.470, p<0.05), body mass index (r=0.472, p<0.05), triceps skinfold thickness (r=0.530, p<0.05), mid-upper arm circumference (r=0.515, p<0.05), mid-upper arm muscle circumference (r=0.557, p<0.05), lean body mass (r=0.470, p<0.05), body fat content (%) (r=0.588, p<0.05), albumin level (r=0.565, p<0.05).

Conclusions. Handgrip strength alongside with more than one method of food consumption, biochemical parameters, subjective global assessment, anthropometric measurements, and body composition should be used for assessing the nutritional status in hemodialysis patients.

https://doi.org/10.21802/gmj.2020.3.4
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References

Runge SM, Greganti MA, Netter FH. Kronik bö brek yetmezliği. In: Netters internal medicine. Ankara: Gü neş Tıp Kitabevleri; 2009; 748-754.

Sungur G, Tekinsoy P, Ceyhan Ö et al. Hemodiyaliz hastalarının evde bakım gereksinimleri. Nefroloji Hemşireliği Dergisi. 2010; 6 (1-2): 28-33.

Eşit Ü M, Karadenizi G. Hemodiyaliz tedavisi gö ren hastaların yaşam kalitesi ve bilgilendirici hemşirelik yaklaşımının ö nemi. Fırat Sağlık Hizmetleri Dergisi. 2006; 1 (1): 33-43.

Carrero JJ, Stenvinkel P, Cuppari L et al. Etiology of the protein-energy wasting syndrome in chronic kidney disease: A consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM). J Ren Nutr. 2013; 23 (2): 77-90. DOI: https://doi.org/10.1053/j.jrn.2013.01.001 [PMid:23428357]

Leal V, Mafra D, Anjos D. Use of handgrip strength in the assessment of the muscle function of chronic disease patients on dialysis: A systematic review. Nephrology Dialysis Transplantation. 2011; 26 (4): 1354-1360. DOI: https://doi.org/10.1093/ndt/gfq487 [PMid:20709742]

Pekcan G. Hastanın beslenme durumunun saptanması. In: Diyet El Kitabı Ankara: Hatipoğlu Yayınevi, 2013; 65-117.

Hillman TE, Nunes QM, Hornby ST et al. A practical posture for handgrip dynamometry in the clinical setting. Clin Nutr. 2005; 24 (2): 224-228. DOI: https://doi.org/10.1016/j.clnu.2004.09.013 [PMid:15784482]

Detsky AS, McLaughlin JR, Baker JP, et al. What is a subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987; 11 (1): 8-13. DOI: https://doi.org/10.1177/014860718701100108 [PMid:3820522]

Lee RD, Nieman DC. Nutritional assessment. WM.C. Oxford: Brow Communications; c1993. 407p.

Bebis (Beslenme Bilgi Sistemi). Nutrition Data Base Software. Database: The German Food Code and Nutrient Data Base (BLS II.3, 1999) with additions from USDA-sr and other sources. Istanbul. 2004.

Zadeh K, Block G, Humphreys M et al. A low, rather than a high, total plasma homocysteine is an indicator of poor outcome in hemodialysis patients. J Am Soc Nephrol. 2004; 15 (2): 442-453. DOI: https://doi.org/10.1097/01.ASN.0000107564.60018.51 [PMid:14747392]

Alpar R. Spor, sağlık ve eğitim bilimlerinden ö rneklerle uygulamalı istatistik ve geç erlik-gü venirlik. Ankara: Nobel Yayınevi; c2016.

Kirushnan BB, Rao BS, Annigeri R et al. Impact of Malnutrition, Inflammation, and Atherosclerosis on the Outcome in Hemodialysis Patients. Indian J Nephrol. 2017; 27 (4): 277-283. DOI: https://doi.org/10.4103/0971-4065.202830 [PMid:28761229 PMCid:PMC5514823]

Koor BE, Nakhaie MR, Babaie S. Nutritional assessment and its correlation with anthropometric measurements in hemodialysis patients. Saudi J Kidney Dis Transpl. 2015; 26 (4): 697-701. DOI: https://doi.org/10.4103/1319-2442.160146 [PMid:26178540]

Pereire RA, Caetano AL, Cuppari L et al. Adductor pollicis muscle thickness as a predictor of handgrip strength in hemodialysis patients. J Bras Nefrol. 2013; 35 (3): 177-184. DOI: https://doi.org/10.5935/0101-2800.20130029 [PMid:24100736]

Kadiri M, Nechba R, Oualim Z. Factors predicting malnutrition in hemodialysis patients. Saudi J Kidney Dis Transpl. 2011; 22 (4): 695-704.

Fouque D, Kalantar-Zadeh K, Kopple J et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008; 73 (4): 391-398. DOI: https://doi.org/10.1038/sj.ki.5002585 [PMid:18094682]

Norman K, Stobä us N, Gonzalez MC et al. Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr. 2011; 30 (2): 135-142. DOI: https://doi.org/10.1016/j.clnu.2010.09.010 [PMid:21035927]

Schlü ssel MM, Anjos LA, Vasconcellos MTL et al. Reference values of handgrip dynamometry of healthy adults: A population-based study. Clin Nutr. 2008; 27 (4): 601-607. DOI: https://doi.org/10.1016/j.clnu.2008.04.004 [PMid:18547686]

Leal VO, Stockler-Pinto MB, Farage NE et al. Handgrip strength and its dialysis determinants in hemodialysis patients. Nutrition. 2011; 27 (11-12): 1125-1129. DOI: https://doi.org/10.1016/j.nut.2010.12.012 [PMid:21454052]

Pinto AP, Ramos CI, Meireles MS et al. Impact of hemodialysis session on handgrip strength. J Bras Nefrol. 2015; 37 (4): 451-457. DOI: https://doi.org/10.5935/0101-2800.20150072 [PMid:26648494]

Morishita Y, Kubo K, Haga Y et al. Skeletal muscle loss is negatively associated with single-pool kt/v and dialysis duration in hemodialysis patients. Ther Apher Dial. 2014; 18 (6): 612-617. DOI: https://doi.org/10.1111/1744-9987.12174 [PMid:24674153]

Vogt BP, Borges MCC, Regina de Goes C et al. Handgrip strength is an independent predictor of all-cause mortality in maintenance dialysis patients. Clin Nutr. 2016; 35 (6): 1429-1433. DOI: https://doi.org/10.1016/j.clnu.2016.03.020 [PMid:27083497]

Carrero JJ, Chmielewski M, Axelsson J et al. Muscle atrophy, inflammation, and clinical outcome in the incident and prevalent dialysis patients. Clin Nutr. 2008; 27 (4): 557-564. DOI: https://doi.org/10.1016/j.clnu.2008.04.007 [PMid:18538898]

Isoyama N, Qureshi HR, Avesani CA et al. Comparative associations of muscle mass and muscle strength with mortality in dialysis patients. Clin J Am Soc Nephrol. 2014; 9 (10): 1720-1728. DOI: https://doi.org/10.2215/CJN.10261013 [PMid:25074839 PMCid:PMC4186520]

National Kidney Foundation. Clinical practice guidelines for nutrition in chronic renal failure. Available from: https://www.kidney.org/professionals/guidelines

İkizler TA. Protein and energy: recommended intake and nutrient supplementation in chronic dialysis patients. Semin Dial. 2004; 17 (6): 471-478. DOI: https://doi.org/10.1111/j.0894-0959.2004.17608.x [PMid:15660578]

Lorenzo V, Boris E, Rufino M et al. Caloric rather than protein deficiency predominates in stable chronic hemodialysis patients. Nephrol Dial Transplant. 1995; 10 (10): 1885-1889.

Booth M, Hunter C, Gore C et al. The relationship between body mass index and waist circumference: implications for estimates of the population prevalence of overweight. Int J Obes Relat Metab Disord. 2000; 24 (8): 1058-1061. DOI: https://doi.org/10.1038/sj.ijo.0801359 [PMid:10951546]

Wang AY, Sea MM, Ho ZS et al. American society for clinical nutrition evaluation of handgrip strength as a nutritional marker and prognostic indicator in peritoneal dialysis patients. Am J Clin Nutr. 2005; 81 (1): 79-86. DOI: https://doi.org/10.1093/ajcn/81.1.79 [PMid:15640464]

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