title: Skeletal muscle loss is negatively associated with single-pool Kt/V and dialysis duration in hemodialysis patients.
abstract: We evaluated the skeletal muscle loss in hemodialysis (HD) patients by bioelectrical impedance analysis (BIA) and handgrip strength test. Thirty-four HD patients and 16 healthy subjects (control group) were measured for skeletal muscle mass normalized as the skeletal muscle mass index (SMI), calculated as skeletal muscle mass (kg)/height (m)(2) using a tetrapolar bioelectrical impedance plethysmograph. Handgrip strength test was also performed using a hand dynamometer in both groups. In HD patients, the associations of SMI and handgrip strength with age, sex, HD conditions, and HD parameters such as body mass index (BMI), single-pool Kt/V (spKt/V), normalized protein catabolic rate (nPCR), creatinine generation rate (CGR) and serum albumin level (Alb) were investigated. SMI of HD patients (4.58 ± 0.95 kg/m(2) ) was significantly lower than that of the control group (5.55 ± 0.80 kg/m(2) , P<0.01). The handgrip strength of HD patients (19.9 ± 7.74 kg) was also significantly lower than that of the control group (33.0 ± 8.94 kg, P<0.01). In HD patients, HD duration was associated with both SMI and handgrip strength. Among HD parameters, spKt/V was negatively associated with both SMI and handgrip strength, BMI and Alb were positively associated with SMI, while nPCR and CGR were associated with neither SMI nor handgrip strength. HD duration independently contributed to skeletal muscle loss and the value of spKt/V may be affected by skeletal muscle loss in HD patients.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan; Department of Dialysis Center, Haga Red Cross Hospital, Mooka, Tochigi, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Morishita
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kubo
authors.forename: Yumi
authors.initials: Y
authors.lastname: Haga
authors.forename: Atushi
authors.initials: A
authors.lastname: Miki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Eiji
authors.initials: E
authors.lastname: Kusano
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nagata
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000473:pathology*; D010992:Plethysmography, Impedance; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D013997:Time Factors
keywords: Bioelectrical impedance analysis; Handgrip strength test; Hemodialysis; Skeletal muscle loss