HAND GRIP STRENGTH AND ITS CORRELATES IN THE ASSESSMENT OF PROTEIN ENERGY MALNUTRITION IN MAINTENANCE HEMODIALYSIS PATIENTS

Nandu Krishnan J., Sebastian Abraham*, Mohandas M. K. and Ragi Krishnan

ABSTRACT

Hand grip strength (HGS) is a simple, reliable and easily reproducible tool to diagnose and monitor protein energy wasting (PEW) in chronic kidney disease (CKD) patients. It is also a powerful predictor of mortality in them. HGS of CKD patients were recorded and correlated with established clinical and anthropometric parameters of PEW and Malnutrition Inflammation Score (MIS). An observational cohort study based on a sample population of one hundred CKD patients on maintenance hemodialysis (MHD) was performed. The demographic details were obtained using proforma, anthropometric measurements taken using tapes and calipers and HGS calculated with handheld mechanical dynamometer. Results were analyzed using SPSS software using multivariate regression analysis and Pearson correlation coefficient to correlate the parameters of PEW. Results: HGS correlated well with gender, MIS, anthropometric measures, body mass index, and biochemical parameters like hemoglobin, albumin, transferrin saturation and did not with age, dialysis vintage, residual renal output, serum urea or creatinine. HGS is a simple and effective tool to identify and monitor protein energy malnutrition in maintenance hemodialysis patients and enable early interventions to address the issues.

Keywords: Hand grip strength (HGS); Chronic kidney disease (CKD); Protein energy wasting (PEW); Maintenance Hemodialysis(MHD); Malnutrition Inflammation Score(MIS).