Use of dynamometry in hemodialysis patients

Abstract

Introduction: Dynamometry is a cheap, simple and easily reproduced method to assess muscle strength (MS), which, like other processes of obtaining measurements, displays high sensitivity and specificity for the early detection of any change in the nutritional status. Objectives: To evaluate factors concerning the reduction in MS in patients undergoing hemodialysis (HD). Methods: A single center, crosssectional study was carried out. The following clinical variables were analyzed: sex, age, blood pressure, weight, significant weight loss within the last 36 months, body mass index (BMI), weight gain in between dialysis sessions, hemodialysis treatment time, diabetes, energy and protein intake. Other factors taken into account were: laboratory findings (hemoglobin, hepatogram, electrolyte panel, calcium test, phosphate test, lipid profile, protein analysis, transferrin saturation) and hand grip strength (before and after dialysis, on both arms) measured through dynamometry. The patients' muscle strength values were compared to those of healthy subjects. Values below the 10th percentile were regarded as abnormal. Mean, median, standard deviation as well as the X2 and the Student's t tests were considered where applicable. A p<0.05 constituted a significant value. Results: There were 73 patients included in this study and 47.95% of them showed low MS with significant strength loss on the arm having the vascular access when compared to the other arm (p 0.00019). A longer hemodialysis treatment time (p 0.026) and a lower BMI (p 0.046) were found to be the two variables with the highest impact on MS. Conclusions: Muscle strength loss in patients undergoing hemodialysis is very common and is associated with a longer HD treatment time and a lower BMI.

Keywords

• dinamometría
• fuerza muscular
• hemodiálisis
• evaluación nutricional
• diálisis renal