| Handgrip strength, but not other nutrition parameters, predicts circulatory congestion in peritoneal dialysis patients. | |
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MedLine Citation:
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PMID: 20400450 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Handgrip strength (HGS) is a marker of lean muscle mass. This study aims to test the hypothesis that a low HGS reflects a diseased cardiac status and predicts future risk of circulatory congestion in chronic peritoneal dialysis (PD) patients. METHODS: Two hundred and eighteen chronic PD patients were prospectively recruited from a single regional dialysis unit in Hong Kong. HGS, serum albumin, lean body mass (LBM) by creatinine kinetics (CK) and subjective global assessment (SGA) were assessed at study entry and examined in relation to the risk of developing circulatory congestion over a 4-year follow-up. RESULTS: Adjusting for age, gender and height, HGS showed significant correlations with LBM by CK, SGA, serum albumin, atherosclerotic vascular disease, left ventricular (LV) mass index and early mitral inflow velocity to peak mitral annulus velocity (E/Em ratio). In the multivariable Cox regression analysis, HGS (P = 0.004) and ejection fraction (P = 0.004) were both second to LV mass index (P < 0.001) as the most significant factors in predicting circulatory congestion at 4 years. Serum albumin, LBM by CK and SGA were not independently predictive of circulatory congestion. Patients with systolic dysfunction and HGS < gender-specific median had an adjusted hazard ratio of 2.77 [95% confidence interval (CI), 1.46-5.28; P = 0.002] in developing circulatory congestion than those with normal systolic function and HGS ≥ gender-specific median. CONCLUSIONS: A low HGS reflects a diseased cardiac status and predicts future risk of circulatory congestion independent of other nutritional, echocardiographic and clinical parameters in PD patients. The important link between skeletal myopathy and myocardial disease in uraemic patients warrants further investigation. |
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Authors:
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Angela Yee-Moon Wang; John E Sanderson; Mandy Man-Mei Sea; Mei Wang; Christopher Wai-Kei Lam; Iris Hiu-Shuen Chan; Siu-Fai Lui; Jean Woo |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-04-16 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 25 ISSN: 1460-2385 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-23 Completed Date: 2011-01-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 3372-9 Citation Subset: IM |
Affiliation:
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Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince ofWales Hospital, Hong Kong. aymwang@hkucc.hku.hk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cohort Studies Creatinine / metabolism Echocardiography Female Hand Strength* Heart Failure / etiology* Humans Male Middle Aged Nutritional Status Peritoneal Dialysis / adverse effects*, mortality Proportional Hazards Models Prospective Studies Serum Albumin / analysis |
| Chemical | |
Reg. No./Substance:
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0/Serum Albumin; 60-27-5/Creatinine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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