Evaluation of handgrip strength as a nutritional marker and prognostic indicator in peritoneal dialysis patients

Wang, Angela Yee-Moon; Sea, Mandy Man-Mei; Ho, Zoe So-Ying; Lui, Siu‐Fai; Li, Philip Kam-Tao; Woo, Jean

doi:10.1093/ajcn/81.1.79

Cited by 176 publications

(105 citation statements)

References 36 publications

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“…Fourth, hand-grip strength as a marker of nutritional status has not been validated in the CHF population. However, it has been validated in the hemodialysis 29,30 and elderly populations, 31,32 2 other populations that exhibit the obesity paradox. Fifth, we used surrogates of mortality in CHF but did not directly assess survival in this study.…”

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confidence: 99%

Association Between Direct Measures of Body Composition and Prognostic Factors in Chronic Heart Failure

Oreopoulos

Ezekowitz

McAlister

et al. 2010

Mayo Clinic Proceedings

135

120

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Objective: To explore the covariate-adjusted associations between body composition (percent body fat and lean body mass) and prognostic factors for mortality in patients with chronic heart failure (CHF) (nutritional status, N-terminal pro-B-type natriuretic peptide [NT-proBNP], quality of life, exercise capacity, and Creactive protein).Patients and MethOds: Between June 2008 and July 2009, we directly measured body composition using dual energy x-ray absorptiometry in 140 patients with systolic and/or diastolic heart failure. We compared body composition and CHF prognostic factors across body fat reference ranges and body mass index (BMI) categories. Multiple linear regression models were created to examine the independent associations between body composition and CHF prognostic factors; we contrasted these with models that used BMI.Results: Use of BMI misclassified body fat status in 51 patients (41%). Body mass index was correlated with both lean body mass (r=0.72) and percent body fat (r=0.67). Lean body mass significantly increased with increasing BMI but not with percent body fat. Body mass index was significantly associated with lower NTproBNP and lower exercise capacity. In contrast, higher percent body fat was associated with a higher serum prealbumin level, lower exercise capacity, and increased C-reactive protein level; lean body mass was inversely associated with NT-proBNP and positively associated with hand-grip strength.cOnclusiOn: When BMI is divided into fat and lean mass components, a higher lean body mass and/or lower fat mass is independently associated with factors that are prognostically advantageous in CHF. Body mass index may not be a good indicator of adiposity and may in fact be a better surrogate for lean body mass in this population.Mayo Clin Proc. 2010;85(7)609-617 6MWD = 6-minute walk distance; BMI = body mass index; CHF = chronic heart failure; CRP = C-reactive protein; DEXA = dual energy x-ray absorptiometry; HRQoL = health-related quality of life; NT-proBNP = N-terminal pro-B-type natriuretic peptide; WHO = World Health Organization

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mentioning

confidence: 99%

Association Between Direct Measures of Body Composition and Prognostic Factors in Chronic Heart Failure

Oreopoulos

Ezekowitz

McAlister

et al. 2010

Mayo Clinic Proceedings

135

120

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“…HGS is known to decrease in patients with CKD. Uremic toxins such as β2-microglobulin, deficiency of carnitine, disturbances of electrolyte metabolisms, hemodynamic factors related to dialysis procedure, increased inflammation and acidosis may all cause lower values of HGS in HD patients (5,7). Low values of HGS were found to predict mortality in both nonuremic and uremic patients (15,16).…”

Section: Discussionmentioning

confidence: 98%

Handgrip Strength and Serum Uric Acid Levels are Associated with Dialysis-Malnutrition Scores in Chronic Hemodialysis Patients

Başçı¹,

Özkök²,

Kacar³

et al. 2017

Turk Neph Dial Transpl

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OBJECTIVE: Protein-energy-wasting (PEW) is common and contributes to increased mortality in hemodialysis (HD) patients. Herein we aimed to investigate the relationships between the parameters of malnutrition including dialysis malnutrition score (DMS), bioimpedance analysis (BIA), handgrip strength (HGS) in chronic HD patients. MATERIAL and METHODS:Forty chronic HD patients (mean age:58±18 years; males:22) were enrolled. Mid-arm circumference (MAC) measurements and BIA were performed. HGS was measured by a Jamar hydraulic hand dynamometer. RESULTS:HGS, MAC and uric acid levels were higher in patients with mild malnutrition compared to severe malnutrition group. Postdialysis creatinine was associated with lean body ratio (LBR) (r=0.56, p=0.002), DMS (r=-0.57, p=<0.001), HGS (r=0.73, p<0.001) and MAC (r=0.51, p=0.001). DMS was inversely correlated with HGS (r= -0.63, p<0.001), MAC (r= -0.48, p=0.002), total protein (r=-0.36, p=0.02) and uric acid levels (r=-0.54, p<0.001). In linear regression analysis (R 2 =0.58; p<0.001), HGS and uric acid were found to independently predict DMS. HGS was associated with MAC, LBR, uric acid and post-HD urea. HGS was negatively correlated with age, DMS, fat tissue ratio (FTR) and Kt/V. In linear regression analysis (R 2 =0.71; p<0.001), gender, DMS and MAC were found to independently predict HGS.CONCLUSION: HGS and uric acid were significantly associated with dialysis-malnutrition scores. HGS is an easy and reliable test for the evaluation of malnutrition in HD patients.KEy wORDS: Malnutrition, Hemodialysis, Handgrip strength, Dialysis malnutrition score, Uric acid Öz AMAÇ: Protein-enerji tükenmesi sendromu, hemodiyaliz (HD) hastalarında sıktır ve artmış mortalite ile ilişkilidir. Burada, el-sıkma gücünün (ESG); diyaliz malnütrisyon skoru (DMS) ve biyoimpedans analizi (BİA) gibi diğer malnütrisyon parametreleri ile ilişkisinin araştırılması amaçlanmıştır. GEREÇ ve yÖNTEMLER:Kırk kronik HD hastası (ortalama yaş: 58±18 yıl; erkek :22) çalışmaya katıldı. Orta-kol çevresi (OKÇ) ve BİA ölçümleri yapıldı. ESG, Jamar hidrolik el dinamometresi ile ölçüldü.BULGULAR: ESG, OKÇ ve ürik asit seviyeleri, hafif malnütrisyon grubunda, ciddi malnütrisyon grubuna göre daha yüksek saptandı. Postdiyaliz kreatinin seviyeleri, yağsız vücut oranı (YVO) (r=0,56, p=0,002), DMS(r= -0,57, p=<0,001), ESG(r=0,73, p<0,001) ve OKÇ(r=0,51, p=0,001) ile anlamlı olarak ilişkili bulundu. DMS ise ESG 63, p<0,001),48, p=0,002),36, p=0,02) ve ürik asit seviyeleri (r=-0,54, p<0,001) ile ters-ilişkili bulundu. Lineer regresyon analizinde (R 2 =0,58; p<0,001), ESG ve ürik asitin DMS'nin bağımsız öngörücüleri olduğu bulundu. ESG ile OKÇ, YVO, ürik asit ve post-HD üre değerleri ilişkiliydi. Buna karşın ESG; yaş, DMS, yağ doku oranı ve Kt/V ile ters ilişkili bulundu. Lineer regresyon analizinde (R 2 =0,71; p<0,001), cinsiyet, DMS ve OKÇ'nin ESG'nin bağımsız öngörücüleri oldukları gösterildi. SONUÇ: ESG ve ürik asit seviyeleri, diyaliz-malnütrisyon skorlarıyla anlamlı olarak ilişkilidir. ESG, HD hastalarında malnütr...

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“…As a marker of LBM, HGS is a good prognostic indicator independent of albumin and CRP (39); it also correlates with malnutrition-inflammation score (40). Extensive losses of muscle mass, strength, and function likely contributes to prolonged recovery, especially in the presence of a preexisting deficiency of muscle mass (41).…”

Section: Discussionmentioning

confidence: 99%

Anthropometrics Identify Wasting in Patients Undergoing Surgery for Encapsulating Peritoneal Sclerosis

Campbell¹,

Augustine²,

Hurst³

et al. 2015

Perit Dial Int

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♦ Introduction: Encapsulating peritoneal sclerosis (EPS) is a serious complication of peritoneal dialysis in which gastrointestinal (GI) symptoms reduce appetite and dietary intake. Adequate nutrition is important, especially if surgery is required. Although the incidence of EPS is low, the present report is able to detail preoperative nutrition status and treatment in a large cohort of patients from a national EPS referral center.

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Evaluation of handgrip strength as a nutritional marker and prognostic indicator in peritoneal dialysis patients

Cited by 176 publications

References 36 publications

Association Between Direct Measures of Body Composition and Prognostic Factors in Chronic Heart Failure

Association Between Direct Measures of Body Composition and Prognostic Factors in Chronic Heart Failure

Handgrip Strength and Serum Uric Acid Levels are Associated with Dialysis-Malnutrition Scores in Chronic Hemodialysis Patients

Anthropometrics Identify Wasting in Patients Undergoing Surgery for Encapsulating Peritoneal Sclerosis

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