ADDUCTOR POLLICIS MUSCLE THICKNESS AS A PREDICTOR OF MUSCLE STRENGTH IN HEMODIALYSIS PATIENTS

Abstract

Muscle mass remains a challenge in the nutritional assessment of hemodialysis (HD) patients. The adductor pollicis muscle thickness (APMt) has emerged as a promising marker of muscle mass in the general population. Thus, we aimed to evaluate whether APMt is able to predict handgrip strength (HGS), a valid muscle mass marker in HD patients. This cross-sectional study evaluated a total of 73 patients (52.3±17 years, 56 months on HD, 48% malnourished by Subjective Global Assessment [SGA] and without residual renal function). The APMt was assessed by a skinfold caliper considering the mean of three measurements. HGS was obtained using a dynamometer. Both methods and other anthropometric parameters were performed in the arm opposite to vascular access and after HD session. Patients were stratified according to gender-specific median HGS (men 24 kg; women 18 kg). APMt values were lower in the group with lower HGS when compared with the group with higher HGS (8,91±4,08 and 11,22±4,64, P=0,02 respectively). A significant correlation was found between AMPt and HGS (r=0,40; P<0,001). Adjusting for sex, age and length on HD, APMt remained independently associated with HGS (β=0,59; CI= 0,07 to 1,11; P=0,03; R2=0,44). Considering functional disorders related to malnutrition appear earlier than morphological changes, the finding that APMt is able to predict muscle strength is of great relevance for the routine care of HD patients.