Background and Aims Gait speed is a predictor of disability, mobility limitation and mortality. Buchner et al. the first to observe a non-linear relationship between leg strength and normal gait speed. This relationship was explained as small changes in physiological capacity. The objective of this study is to assess the relationship between gait speed and body composition in haemodialysis. Method Cross-sectional study in 40 subjects with CKD in hospital haemodialysis, 70.5±13.03 years, 62.5% male. 40% Diabetic Nephropathy, 10% Glomerulopathies, 7.5% Nephroangiosclerosis, 2.5% Chronic Tubule-Interstitial Nephropathies, 32.5% Unknown, 2.5% Others. 35% arteriovenous fistula, 10% arteriovenous graft, 55% central venous catheter. Haemodialysis type: 40% High Flux, 45% Online postdilutional Haemodiafiltration, 10% Acetate Free Biofiltration. Gait seed was measured on the middle day of the week, predialysis. Body composition was estimated by monofrecuency bioimpedance measurement (50 KHz) on the middle day of the week, posthemodiálisis. Statistical analysis was performed with SPSS 13.0. Results Average gait speed 0.6±0.38 m/s, median 0.65 (IQR 0.18) m/s, range (0, 1.23) m/s. The prevalence of a gait speed less than or equal to 0.8 m/s was 67.5%, while 32.5% of the patients presented a gait speed less than or equal to 0.8 m/s. Gait speed was lower among diabetics (0.77±0.3 vs 0.46±0.39, p=0.0074). A positive and significant correlation was observed between gait speed and phase angle. No correlation was observed between gait speed and body fat. A positive linear relationship or dependence was observed between gait speed and muscle mass and cell mass. In relation to body water, a negative linear relationship is observed with the EW/IW ratio. Table 1. Conclusion There is a dependent relationship between gait speed and diabetes in haemodialysis patients. The decrease of the phase angle, the increase of the ratio EW/IW changes with the decrease the cell mass index are inversely related to the gait speed in haemodialysis patients. These items and the gait speed, which provide information on the state of vulnerability of the patient, could be markers of frailty.
Background and Aims Frailty is known as a biological syndrome of decreased reserves and resistance to stress, with a decline of multiple physiological systems, causing vulnerability. Its prevalence ranges from 10-80 %. The etiopathogenesis is multifactorial, based on the loss of muscle mass associated with aging or sarcopenia. Chronic Kidney Disease (CKD) is a model of accelerated aging, with impaired physical function, frailty and cognitive decline. The main theorical frameworks on frailty are the one advocated by Linda Fried, in which she develops a phenotype as a risk situation for developing disability and one advocated by Kennet Rockwood which establishes that frailty consists of addition of various health conditions including comorbidity and disability. Our objective was to evaluate frailty in stage 5 CKD in haemodialysis, measured by clinical scale and to relate it to the body composition measured by bioimpedance. Method Cross-sectional study in 40 subjects with CKD in hospital haemodialysis, 70.5±13.03 years, 62.5% male. 40% Diabetic Nephropathy, 10% Glomerulopathies, 7.5% Nephroangiosclerosis, 2.5% Chronic Tubule-Interstitial Nephropathies, 32.5% Unknow, 2.5% Others. 35% arteriovenous fistula, 10% arteriovenous graft, 55% central venous catheter. Hemodialysis type: 40% High Flux, 45% Online postdilutional Haemodiafiltration, 10% Acetate Free Biofiltration. Fragility was measured by the Rockwood clinical scale: not fragile (1-4), moderately fragile (5-6) and severely fragile (7-9). Body composition was estimated by monofrequency bioimpedance measurement. Chi-Cuadrado was used to study differences between dichotomous variables and ANOVA for continuous variables. Spearman correlation´s was used to examinate the intensity of association between two quantitative variables. Statistical analysis was performed with SPSS 13.0. Results 42.5% of the subjects presented a degree of fragility ≥5, severely fragile 27.5%. The results are shown in the Tables 1 and 2. Conclusion The degree of frailty is greater in the elderly. Measurement of body composition by bioimpedance can be useful to indirectly asses frailty. The phase angle could be an indicator of fragility, since in more fragile subjects its value decreases, its physiological role remains to be elucidated. There is a positive trend to an increase in extracellular water in more fragile subjects, keeping the subjects in their dry weight, so it will be necessary to evaluate what is due.
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