Keruo Jiang1, Adrian Slee2, Andrew Davenport3. 1. UCL Clinical and Public Health Nutrition, University College London, London, UK. 2. UCL Division of Medicine, Faculty of Medical Sciences, University College London, London, UK. 3. UCL Department of Nephrology, Royal Free Hospital, University College London, London, UK.
Abstract
BACKGROUND: Chronic kidney disease (CKD) patients commonly report muscle weakness and fatigue. Losing muscle mass increases mortality. Accordingly, we aimed to determine the main factors associated with loss of muscle mass and muscle weakness. METHODS: Anthropometric measurements were made in CKD patients attending a specialised clinic, along with hand grip strength (HGS), pinch strength (PS) and body composition (muscle mass and fat mass), using segmental bioimpedance assessment. RESULTS: We reviewed the results of 161 CKD patients; 105 male (65.2%), mean (SD) age 70.3 (15) years, body mass index (BMI) 28.8 (6.7) kg m-2 . In multivariable models, both HGS and PS were independently negatively associated with age [standardised β (St β) = 0.35; 95% confidence limits (CL) = -0.32 to -0.14; St β = 0.38; 95% CL = -0.65 to -0.02; P < 0.001, respectively] and positively with appendicular muscle in the arm tested [St β = 0.34; 95% CL = 2.5-6.3; St β = 0.24; 95% CL = 0.17-0.98; P < 0.001 and P = 0.006, respectively]. In addition, HGS was associated with male gender (St β = 0.19; 95% CL = 0.7-7.5; P = 0.019] and negatively with percentage body fat (St β = 0.22; 95% CL = -0.36 to -0.07; P = 0.003]. There were 47 (29.2%) Asian patients who had lower total skeletal muscle mass/height ratio and appendicular muscle mass/BMI ratio compared to other ethnicities [9.6 (1.8) versus 10.5 (1.6) kg m-2 , P < 0.01; 0.73 (0.23) versus 0.83 (0.33) m2 ; P < 0.01). CONCLUSIONS: In CKD patients, we found that muscle weakness measured by HGS and PS was associated with increasing age and loss of appendicular muscle mass. HGS was also weaker with increasing fat mass and female gender, whereas PS was weaker in patients of Asian ethnicity.
BACKGROUND: Chronic kidney disease (CKD) patients commonly report muscle weakness and fatigue. Losing muscle mass increases mortality. Accordingly, we aimed to determine the main factors associated with loss of muscle mass and muscle weakness. METHODS: Anthropometric measurements were made in CKD patients attending a specialised clinic, along with hand grip strength (HGS), pinch strength (PS) and body composition (muscle mass and fat mass), using segmental bioimpedance assessment. RESULTS: We reviewed the results of 161 CKD patients; 105 male (65.2%), mean (SD) age 70.3 (15) years, body mass index (BMI) 28.8 (6.7) kg m-2 . In multivariable models, both HGS and PS were independently negatively associated with age [standardised β (St β) = 0.35; 95% confidence limits (CL) = -0.32 to -0.14; St β = 0.38; 95% CL = -0.65 to -0.02; P < 0.001, respectively] and positively with appendicular muscle in the arm tested [St β = 0.34; 95% CL = 2.5-6.3; St β = 0.24; 95% CL = 0.17-0.98; P < 0.001 and P = 0.006, respectively]. In addition, HGS was associated with male gender (St β = 0.19; 95% CL = 0.7-7.5; P = 0.019] and negatively with percentage body fat (St β = 0.22; 95% CL = -0.36 to -0.07; P = 0.003]. There were 47 (29.2%) Asian patients who had lower total skeletal muscle mass/height ratio and appendicular muscle mass/BMI ratio compared to other ethnicities [9.6 (1.8) versus 10.5 (1.6) kg m-2 , P < 0.01; 0.73 (0.23) versus 0.83 (0.33) m2 ; P < 0.01). CONCLUSIONS: In CKD patients, we found that muscle weakness measured by HGS and PS was associated with increasing age and loss of appendicular muscle mass. HGS was also weaker with increasing fat mass and female gender, whereas PS was weaker in patients of Asian ethnicity.