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Abstract: TH-PO309

The Association Between Handgrip Strength (HGS) and Predialysis Sodium (sNa) in Patients with CKD Stage 5D

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kyriazis, Periklis Panos, Baystate Medical Center/University of Massachussetts, Springfield, Massachusetts, United States
  • Markaki, Anastasia, Technological Educational Institute of Crete, Siteia, Crete, Greece
  • Dermitzaki, Eleftheria-Kleio, University Hospital of Heraklion, Heraklion, Crete, Greece
  • Lygerou, Dimitra, University Hospital of Heraklion, Heraklion, Crete, Greece
  • Spyridaki, Aspasia, Technological Educational Institute of Crete, Siteia, Crete, Greece
  • Psylinakis, Emmanouil, Technological Educational Institute of Crete, Siteia, Crete, Greece
  • Kanellos, Panagiotis T., Technological Educational Institute of Crete, Siteia, Crete, Greece
  • Gioume, Argyro, Technological Educational Institute of Crete, Siteia, Crete, Greece
  • Kyriakidi, Konstantina, Technological Educational Institute of Crete, Siteia, Crete, Greece
  • Kalemikiarakis, Nikolaos, Technological Educational Institute of Crete, Siteia, Crete, Greece
Background

HGS is a useful tool for continuous and systematic assessment of muscle function related to nutritional status. Reduced HGS has been associated with adverse clinical outcomes in patients with stage 5D CKD. In the same patients, low sNa has been associated with malnutrition and mortality. Here, we investigated the role of sNa on muscle mass and function in stage 5D CKD patients.

Methods

We evaluated 73 CKD stage 5D (45 on hemodialysis and 28 on peritoneal dialysis) patients (43 men and 30 women) with HGS, bioimpedance analysis (BIA), anthropometric measurements and malnutrition inflammation score (MIS). According to the diagnostic criteria for sarcopenia established by EWGSOP, patients were diagnosed with reduced HGS, if HGS was below 30 Kg and 20 Kg in men and women, respectively. Predialysis sNa values were defined as the mean of all predialysis measurements available during the preceding 6 months.

Results

Patients with reduced (n=28) as compared to the those with normal HGS (n=45) were older in age (p=0.006), had lower skeletal muscle index (SMI) (p=0.004), mid-arm muscle circumference (MAMC) (p=0.043), sNa (137±2.3 vs. 139.5 ± 2.2 mmol/L; p=0.004), serum albumin (sAlb) (p=0.029) and higher MIS (5.13±2.62 vs. 3.82±2.34; p=0.034). In multivariate logistic analysis, after controlling for age, SMI, MAMC, sAlb and MIS, each increase in sNa by 1 mmol/l was associated with 28 % (OR= 0.72, 95% CI: 0.55-0.94; p <0.05) lower odds of having reduced HGS. sNa was positively associated with HGS (r=0.384; p<0.001) and SMI (r=0.295; p<0.05). In a forward stepwise multivariate (sex, SMI, MAMC, sALB, MIS) model (R2= 0.499; p<0.001), sNa, along with SMI and sex, emerged as a strong independent predictor of HGS (B=0.791; p<0.05) explaining about 3 % of its variance.

Conclusion

Our results show that a) sNa is strongly associated with both muscle mass and muscle function, b) sNa impacts on muscle strength independently of muscle mass, nutritional status and inflammatory state and c) irrespective of the mechanism(s) underlying the HGS-sNa association, optimizing predialysis sNa may improve HGS and thus clinical outcomes in 5D CKD patients.