Gait speed and handgrip strength as predictors of all-cause mortality and cardiovascular events in hemodialysis patients.
Adult
Age Factors
Aged
Aged, 80 and over
Cardiovascular Diseases
/ epidemiology
Cognitive Dysfunction
/ epidemiology
Comorbidity
Diabetes Mellitus
/ epidemiology
Female
Hand Strength
Health Status
Humans
Kidney Failure, Chronic
/ epidemiology
Male
Matrix Metalloproteinase 7
/ blood
Middle Aged
Mortality
Neoplasm Proteins
/ blood
Physical Functional Performance
Prospective Studies
Proteoglycans
/ blood
Quality of Life
Renal Dialysis
Republic of Korea
/ epidemiology
Risk Factors
Serum Albumin
/ metabolism
Walking Speed
Gait speed
Handgrip strength
Hemodialysis
Mortality
Physical performance
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
06 05 2020
06 05 2020
Historique:
received:
14
01
2020
accepted:
27
04
2020
entrez:
8
5
2020
pubmed:
8
5
2020
medline:
26
8
2021
Statut:
epublish
Résumé
Low physical performance in patients undergoing maintenance hemodialysis is associated with a high mortality rate. We investigated the clinical relevance of gait speed and handgrip strength, the two most commonly used methods of assessing physical performance. We obtained data regarding gait speed and handgrip strength from 277 hemodialysis patients and evaluated their relationships with baseline parameters, mental health, plasma inflammatory markers, and major adverse clinical outcomes. Low physical performance was defined by the recommendations suggested by the Asian Working Group on Sarcopenia. The prevalence of low gait speed and handgrip strength was 28.2 and 44.8%, respectively. Old age, low serum albumin levels, high comorbidity index score, and impaired cognitive functions were associated with low physical performance. Patients with isolated low gait speed exhibited a general trend for worse quality of life than those with isolated low handgrip strength. Gait speed and handgrip strength showed very weak correlations with different determining factors (older age, the presence of diabetes, and lower serum albumin level for low gait speed, and lower body mass index and the presence of previous cardiovascular events for low handgrip strength). Patients with low gait speed and handgrip strength had elevated levels of plasma endocan and matrix metalloproteinase-7 and the highest risks for all-cause mortality and cardiovascular events among the groups (adjusted hazard ratio of 2.72, p = 0.024). Elderly patients with low gait speed and handgrip strength were at the highest risk for poor clinical outcomes. Gait speed and handgrip strength reflected distinctive aspects of patient characteristics and the use of both factors improved the prediction of adverse clinical outcomes in hemodialysis patients. Gait speed seems to be a better indicator of poor patient outcomes than is handgrip strength.
Sections du résumé
BACKGROUND
Low physical performance in patients undergoing maintenance hemodialysis is associated with a high mortality rate. We investigated the clinical relevance of gait speed and handgrip strength, the two most commonly used methods of assessing physical performance.
METHODS
We obtained data regarding gait speed and handgrip strength from 277 hemodialysis patients and evaluated their relationships with baseline parameters, mental health, plasma inflammatory markers, and major adverse clinical outcomes. Low physical performance was defined by the recommendations suggested by the Asian Working Group on Sarcopenia.
RESULTS
The prevalence of low gait speed and handgrip strength was 28.2 and 44.8%, respectively. Old age, low serum albumin levels, high comorbidity index score, and impaired cognitive functions were associated with low physical performance. Patients with isolated low gait speed exhibited a general trend for worse quality of life than those with isolated low handgrip strength. Gait speed and handgrip strength showed very weak correlations with different determining factors (older age, the presence of diabetes, and lower serum albumin level for low gait speed, and lower body mass index and the presence of previous cardiovascular events for low handgrip strength). Patients with low gait speed and handgrip strength had elevated levels of plasma endocan and matrix metalloproteinase-7 and the highest risks for all-cause mortality and cardiovascular events among the groups (adjusted hazard ratio of 2.72, p = 0.024). Elderly patients with low gait speed and handgrip strength were at the highest risk for poor clinical outcomes.
CONCLUSION
Gait speed and handgrip strength reflected distinctive aspects of patient characteristics and the use of both factors improved the prediction of adverse clinical outcomes in hemodialysis patients. Gait speed seems to be a better indicator of poor patient outcomes than is handgrip strength.
Identifiants
pubmed: 32375664
doi: 10.1186/s12882-020-01831-8
pii: 10.1186/s12882-020-01831-8
pmc: PMC7203881
doi:
Substances chimiques
ESM1 protein, human
0
Neoplasm Proteins
0
Proteoglycans
0
Serum Albumin
0
MMP7 protein, human
EC 3.4.24.23
Matrix Metalloproteinase 7
EC 3.4.24.23
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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