Characterization of deficits across the spectrum of motor abilities in dialysis patients and the impact of sarcopenic overweight and obesity.
Physical performance deficits in kidney failure predict mortality and quality of life. We aimed to quantify deficits in multiple motor abilities, investigate associations of lean and fat tissue content with test results and analyzed performance of sarcopenic individuals with adipose tissue excess.



Ninety hemodialysis patients and 140 healthy controls performed 6-minute walk test, gait speed measurement, sit-to-stand and time up and go tests, upper extremity handgrip and tapping tests, Stork balance and forward bend flexibility tests. Human Activity Profile questionnaire was used to assess habitual activity. Body composition was measured by bioimpedance analysis.



Relative performance deficit of dialysis patients in age, sex, height and comorbidity adjusted estimated marginal means was largest for balance and flexibility (-52 and -33%), followed by lower extremity deficits in sit-to-stand, time up and go and 6-minute walk tests (-29, -19 and -15%, respectively), p < 0.05 for all comparisons. Upper extremity performance was less affected. Lean tissue index associated significantly positively with five and fat tissue index associated significantly negatively with two out of nine tests. Sarcopenic overweight and obese individuals exhibited significant deficits mainly in lower extremity tests with worse composite lower extremity score when compared to other categories of body composition.



Patients with hemodialysis treated kidney failure have largest functional deficits in balance, flexibility and lower extremity functions. Lean and fat mass associate oppositely with physical performance measures and individuals at unfavorable extremes of these indices express significantly impaired lower extremity functions.
Faculty of Sport, University of Ljubljana, Gortanova 22, 1000 Ljubljana, Slovenia. Electronic address: maja.bucarpajek@fsp.uni-lj.si.
Maja
M
Bučar Pajek
Department of Nephrology, University Medical Centre Ljubljana, Zaloška 2, 1525 Ljubljana, Slovenia. Electronic address: Jernej.pajek@mf.uni-lj.si.
Jernej
J
Pajek
D000328:Adult; D000368:Aged; D001823:Body Composition; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D000076604:Physical Functional Performance; D018583:Pliability; D006435:Renal Dialysis / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000628:therapy*; D055948:Sarcopenia / Q000150:complications*
Body composition; Exercise; Lower extremity; Physical fitness; Renal insufficiency