Are Mid-Dialysis Handgrip Strength Measurements Reliable and Reproducible? A Comparison to Predialysis Handgrip...

Area of Science:

• Nephrology
• Clinical Nutrition
• Biometrics

Background:

• Handgrip strength (HGS) is a key indicator of nutritional status.
• Current guidelines suggest pre-hemodialysis (HD) HGS measurement, which can be challenging.
• Mid-dialysis HGS measurement is often a practical alternative.

Purpose of the Study:

• To assess the reliability and reproducibility of HGS measurements.
• To determine the agreement between pre- and mid-dialysis HGS measurements.
• To evaluate the clinical utility of mid-dialysis HGS for nutritional assessment in HD patients.

Main Methods:

• Recruited 48 stable HD patients from four Australian units.
• Measured HGS in triplicate pre- and mid-dialysis over three weeks.
• Utilized Bland Altman plots and linear mixed models for data analysis.

Main Results:

• HGS values were statistically, but not clinically, higher pre-dialysis (19.7 kg) versus mid-dialysis (18.8 kg).
• Bland Altman analysis showed acceptable agreement between pre- and mid-dialysis HGS.
• Confounding factors did not significantly impact the differences in HGS measurements.

Conclusions:

• Handgrip strength measurements are reliable and reproducible whether taken pre- or mid-dialysis.
• Mid-dialysis HGS measurements demonstrate acceptable agreement with pre-dialysis values.
• Mid-dialysis HGS can be reliably used for nutritional assessment in hemodialysis patients.