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Abstract: TH-PO789

Indoxyl Sulfate Mediated Lower Handgrip Strength, in Comparison With Sarcopenia, Was Predictive of Higher Hospitalization in ESRD Patients

Session Information

Category: Geriatric Nephrology

  • 1200 Geriatric Nephrology


  • Hou, Yi-Chou, Cardinal Tien Hospital, New Taipei City, Taiwan
  • Lu, Kuo-Cheng, Taipei Tzu Chi Hospital, New Taipei City, Taiwan

Sarcopenia is common in patients with chronic kidney disease (CKD)/end stage kidney disease (ESRD) than in normal patients. Lower handgrip strength, in comparison with sarcopenia, is associated with clinical outcome including cardiovascular mortality and hospitalization in CKD subjects. The study is to elucidate if uremic toxin contributes to the lower handgrip strength in CKD/ESRD patients.


The participants of the study were divided into three groups: control group (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min), advanced CKD (eGFR = 15–60 mL/min), and ESRD(under maintenance renal replacement therapy). All participants received handgrip strength measurement, dual-energy X-ray absorptiometry, blood sampling for myokine and indoxyl sulfate. Sarcopenia was with lower appendicular skeletal muscle index (appendicular skeletal muscle/height2) of <7.0 kg/m2 in men and <5.4 kg/m2 in women) and lower handgrip strength (handgrip strength of <28 kg in men and <18 kg in women).


The ESRD group had the highest number of participants with lower handgrip strength (41.6% vs 25% and 5.85% in the control and CKD groups, respectively, p < 0.05). The percentage of sarcopenia was similar between group (p=0.864). Lower handgrip strength was associated with higher hospitalization within total population (p=0.02) during 600 days of following up. The serum concentration of indoxyl sulfate was higher in the ESRD group(227.29±92.65uM, vs 41.97 ±43.96uM for CKD group and 6.54±3.45uM for control group, p<0.05).Indoxyl sulfate was associative to lower handgrip strength in univariate (OR: 3.485, 95%CI:1.372-8.852, p=0.001) and multivariable logistic regression (OR: 8.525, 95% CI:1.807-40.207, p=0.007).


Handgrip strength was lower in the ESRD patients. The lower handgrip strength was predictive to the hospitalization in the total population. Indoxyl sulfate contributed to lower handgrip strength associated with lower handgrip strength and counteract the effect of myokine in CKD patients.