title: Handgrip strength is an independent predictor of all-cause mortality in maintenance dialysis patients.
abstract: Muscle wasting is associated with mortality in dialysis patients. The measurement of muscle mass has some limitations, while muscle strength assessment is simple, safe and allows the recognition of patients at risk of progressing to poor outcomes related to malnutrition. The aim of this study is verify if handgrip strength (HGS) is associated with all-cause mortality in patients in maintenance haemodialysis (HD) and peritoneal dialysis (PD).
  
  
  
  This was an observational retrospective cohort study which included all patients in maintenance HD and PD from July 2012 to October 2014. Patients were followed-up until June 2015.
  
  
  
  Two-hundred sixty five patients were enrolled (218 HD and 47 PD) and they were followed for 13.4 ± 7.9 months. During the follow-up period, 53 patients (20%) have died, 36 patients (13.6%) have undergone renal transplantation, 13 patients (4.9%) have switched off dialysis method and 5 patients (1.9%) have transferred to another facility. The cut-off of HGS able to predict mortality was 22.5 kg for men and 7 kg for women. Using this cut-off to fit the Kaplan-Meier survival curve, the association of HGS with all-cause mortality for both genders was confirmed. Finally, in the multivariate analysis adjusted for demographic, clinical and nutritional variables, HGS remained significant predictor of mortality, independent of dialysis modality.
  
  
  
  HGS cut-offs that predict mortality were 22.5 kg for men and 7 kg for women. HGS was associated with mortality independent of dialysis modality.
authors.affiliation: Faculdade de Medicina de Botucatu, UNESP Univ Estadual Paulista, Department of Clinical Medicine, Botucatu, São Paulo, Brazil.
authors.forename: Barbara Perez
authors.initials: BP
authors.lastname: Vogt
authors.affiliation: Faculdade de Medicina de Botucatu, UNESP Univ Estadual Paulista, Department of Clinical Medicine, Botucatu, São Paulo, Brazil.
authors.forename: Mariana Clementoni Costa
authors.initials: MCC
authors.lastname: Borges
authors.affiliation: Faculdade de Medicina de Botucatu, UNESP Univ Estadual Paulista, Department of Clinical Medicine, Botucatu, São Paulo, Brazil.
authors.forename: Cassiana Regina de
authors.initials: CR
authors.lastname: Goés
authors.affiliation: Faculdade de Medicina de Botucatu, UNESP Univ Estadual Paulista, Department of Clinical Medicine, Botucatu, São Paulo, Brazil. Electronic address: jteixeir@fmb.unesp.br.
authors.forename: Jacqueline Costa Teixeira
authors.initials: JCT
authors.lastname: Caramori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D010530:Peritoneal Dialysis; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D055815:Young Adult
keywords: Dialysis; Handgrip strength; Mortality; Nutritional assessment