Handgrip strength as a predictor of mobility in patients with end-stage renal disease on hemodialysis

Abstract

Background: The Timed Up and Go (TUG) test is commonly used to assess motor function and gait stability in the elderly, including patients with chronic kidney disease (CKD). Furthermore, the handgrip strength test is used to evaluate general muscle strength and may help identify weakness, a key element of frailty. Objectives: This study aimed to determine whether the handgrip strength test is a suitable screening tool before the TUG test because it requires less physical effort and likelihood of adverse events associated with falling during testing. Methods: A total of 120 patients with CKD on hemodialysis participated in the study. The associations or correlations among handgrip strength, TUG test, and routine nutritional biomarkers were analyzed. Results: A significant correlation was observed between handgrip strength and TUG test in all patients (R = −0.39, P = 1*10-5), even in patients with diabetic kidney disease (n = 56, R = −0.36, P = 0.0065). Interestingly, when dividing the patients into two groups according to hemoglobin A1c (HbA1c) levels (<7% vs. ≥7%), no significant differences in handgrip strength or completion time of the TUG test were observed between both groups. Conclusion: In patients on hemodialysis with decreased mobility, measuring grip strength can be a reliable marker as an initial screening to determine whether patients can exert the necessary physical effort to perform the TUG test. Furthermore, a HbA1c <7% did not provide additional benefits in terms of muscle strength and mobility to patients with diabetes on hemodialysis.

Keywords

• chronic kidney disease
• handgrip strength test
• timed up and go test