Abstract: SA-PO175

Risk Factors for the Decreased Upper Limb Muscle Strength in MHD Patients

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Zhang, Qian, Huashan Hospital, Fudan University, Shanghai, China
  • Zhang, Jiaying, Fudan University, Shanghai, China
  • Zhang, Minmin, Huashan Hospital, Fudan Univerisy, Shanghai, China
  • Chen, Jing, Huashan Hospital affiliated to Fudan University, Shanghai, China
Background

To assess the risk factors for the decreased biceps muscle strength in young (<65 years) and old (≥65years) MHD patients

Methods

This is a cross-sectional analysis with prospective follow-up from MHD patients. All patients underwent assessment of strength of the biceps, body composition, anthropometry, dietary intake, nutritional status and the daily steps. Blood samples were obtained on the midweek dialysis day. Univariate and multivariate regression analysis was used to analyze the predictors of the decreased upper limb muscle strength. Survival analysis was made with the Kaplan–Meier survival curve and the Cox proportional hazard model.

Results

174 patients were selected, 93 were male and 81 were female patients. The mean age was 63.05±12.29 ys, and the dialysis vintage was 9.19±6.66 ys. Patients were divided into young MHD group (n=97) and elderly MHD group (n=77). In young MHD group, gender (β = -2.01, P = 0.003), modified SGA score (β = -0.29, P = 0.03), muscle mass (β = 0.09, P = 0.03), 25(OH)D level (β = 0.04, P = 0.03) and IL-6 (β = -0.09, P = 0.002) were associated with the decreased biceps muscle strength. In the elderly MHD group, age(β=-0.25, P<0.001), muscle mass(β=0.08, P=0.03), 25(OH)D(β=0.08, P=0.001)and Log NT-proBNP(β=-1.62, P=0.008) were associated with the decreased biceps muscle strength. Patients were further divided into four groups according to 25(OH)D<25,25-50,50-75 and ≥75 nmol/L. Comparing the biceps muscle strength between the groups, it was found that the biceps muscle strength gradually increased with the gradual increase of 25(OH)D levels. During the follow-up of 52 weeks, 16 patients died. 14 of whom died of cardiovascular and cerebrovascular diseases and 2 died of tumor. Kaplan-Merier showed that the survival rate was significantly high in the high muscle strength group than that in low muscle strength group (P=0.002). Cox multivariate analysis showed that the association between low muscle strength and higher mortality risk remained strong in fully adjusted models.

Conclusion

In young MHD group, gender, modified SGA score, muscle mass, 25(OH)D and IL-6 were associated with the decreased biceps muscle strength. In the elderly MHD group, age, muscle mass, 25(OH)D and NT-proBNP were associated with the decreased biceps muscle strength. The biceps muscle strength was an independent risk factor for the survival of MHD patients.