Association of hand grip strength and laboratory markers with frailty in patients on maintenance hemodialysis
DOI:
https://doi.org/10.53685/jshmdc.v6i2.329Keywords:
Chronic Kidney Failure, Frailty, Hand Strength, Physical Functional Performance, Renal DialysisAbstract
Background: Frailty is a common yet under-recognised problem in end-stage renal disease.
Objective: To assess the association between frailty and hand grip strength and to evaluate laboratory parameters as predictors of frailty in patients on maintenance hemodialysis.
Methods: This study was conducted at Combined Military Hospital, Lahore, from January to February 2025, among adolescent and adult patients with end-stage renal disease undergoing maintenance haemodialysis. Key exclusion criteria included physical disabilities, poor functional status, acute kidney injury, and unwillingness. Before the start of the mid-week haemodialysis session, hand grip strength was tested on both sides three times using a handheld digital dynamometer, and the best value was recorded. The Short Physical Performance Battery (SPPB) was also administered to all patients, with scores <10 indicating frailty. Blood samples were also collected to check haemoglobin, serum calcium, phosphate, albumin, creatinine, potassium, C-reactive protein, and bicarbonate levels. Statistical analyses were performed using Spearman's rank correlation test, binary logistic regression, and receiver Operating Characteristic (ROC) curve analysis.
Results: A total of 105 patients with a mean age of 55.00 ± 14.96 years were included. The mean hand grip strength was 14.32 ± 6.80 kg, below the normal reference values (>28 kg for males and >18 kg for females). Mean hand grip strength was 15.11 ± 6.95 kg on the right side and 13.52 ± 6.96 kg on the left side. The median (IQR) SPPB score was 8.00 (4.50–10.00). SPPB score showed a significant correlation with hand grip strength (r² = 0.311; p < 0.001). A hand grip strength cutoff of ≥16.95 kg demonstrated a sensitivity of 65.71% and specificity of 81.43% for discriminating non-frail status (SPPB ≥10) (AUC = 0.781; p < 0.001). None of the laboratory parameters were independent predictors of frailty (p > 0.05).
Conclusion: Hand grip strength is associated with frailty and can discriminate non-frail status, while laboratory parameters are not independent predictors of frailty.
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