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

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 (R2 =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 (R2 =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.