Relationship between malnutrition and possible sarcopenia in the AWGS 2019 consensus affecting mortality in hemodialysis patients: a prospective cohort study
Abstract Background The first objective of this study was to determine the relationship between muscle strength or physical performance and mortality, and the second objective was to show the relationship of Geriatric Nutritional Risk Index (GNRI) to muscle strength and physical performance decline....
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-11-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-021-02566-w |
| _version_ | 1798033187729833984 |
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| author | Kenichi Kono Yoshifumi Moriyama Hiroki Yabe Ayaka Hara Takeki Ishida Tetsuya Yamada Yusuke Nishida |
| author_facet | Kenichi Kono Yoshifumi Moriyama Hiroki Yabe Ayaka Hara Takeki Ishida Tetsuya Yamada Yusuke Nishida |
| author_sort | Kenichi Kono |
| collection | DOAJ |
| description | Abstract Background The first objective of this study was to determine the relationship between muscle strength or physical performance and mortality, and the second objective was to show the relationship of Geriatric Nutritional Risk Index (GNRI) to muscle strength and physical performance decline. Methods We examined handgrip, the 5-times chair stand test, and GNRI in 635 maintenance hemodialysis patients and followed up for 72 months. Predictors for all-cause death were examined using Kaplan-Meier analysis and Cox proportional analysis. The relationship between possible sarcopenia and nutritional disorder (GNRI) was constructed receiver operating characteristic (ROC) curve. We used the Youden index to determine the optimal cutoff points for GNRI. Results The multivariate Cox proportional hazard analysis revealed that the GNRI did not show any significance, although handgrip (HR 3.61, 95% CI 1.70–7.68, p < 0.001) and the 5-times chair stand test (HR 1.71 95% CI 1.01–2.90, p = 0.045) were significant predictors for mortality. On the evaluation of possible sarcopenia by handgrip strength, the area under curve (AUC) on ROC curve analysis were 0.68 (95% CI 0.64–0.72), and 5-chair stand, the AUC on ROC were 0.55 (95% CI 0.51–0.60). The cut-off value for the GNRI discriminating those at possible sarcopenia by handgrip strength based on the Youden index was 91.5. Conclusions Our study suggests that the handgrip strength test of the AWGS 2019 sarcopenia consensus was a simple and useful tool to predict mortality in chronic hemodialysis patients. Furthermore, GNRI assessment can be a useful tool for screening before assessing possible sarcopenia when it is difficult to perform SARC-F to all patients. |
| first_indexed | 2024-04-11T20:26:17Z |
| format | Article |
| id | doaj.art-a69aa1eff06f4be18951f05f19a1bd5e |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-11T20:26:17Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-a69aa1eff06f4be18951f05f19a1bd5e2022-12-22T04:04:40ZengBMCBMC Nephrology1471-23692021-11-012211710.1186/s12882-021-02566-wRelationship between malnutrition and possible sarcopenia in the AWGS 2019 consensus affecting mortality in hemodialysis patients: a prospective cohort studyKenichi Kono0Yoshifumi Moriyama1Hiroki Yabe2Ayaka Hara3Takeki Ishida4Tetsuya Yamada5Yusuke Nishida6Department of Physical Therapy, International University of Health and Welfare Graduate SchoolDepartment of Rehabilitation, Kaikoukai Nagoya Kyoritsu HospitalDepartment of Physical Therapy, Seirei Christopher University. School of RehabilitationDialysis division at Shizuoka, KaishokaiDepartment of Physical Therapy, International University of Health and Welfare Graduate SchoolDialysis division, Kaikoukai Healthcare GroupDepartment of Physical Therapy, International University of Health and Welfare Graduate SchoolAbstract Background The first objective of this study was to determine the relationship between muscle strength or physical performance and mortality, and the second objective was to show the relationship of Geriatric Nutritional Risk Index (GNRI) to muscle strength and physical performance decline. Methods We examined handgrip, the 5-times chair stand test, and GNRI in 635 maintenance hemodialysis patients and followed up for 72 months. Predictors for all-cause death were examined using Kaplan-Meier analysis and Cox proportional analysis. The relationship between possible sarcopenia and nutritional disorder (GNRI) was constructed receiver operating characteristic (ROC) curve. We used the Youden index to determine the optimal cutoff points for GNRI. Results The multivariate Cox proportional hazard analysis revealed that the GNRI did not show any significance, although handgrip (HR 3.61, 95% CI 1.70–7.68, p < 0.001) and the 5-times chair stand test (HR 1.71 95% CI 1.01–2.90, p = 0.045) were significant predictors for mortality. On the evaluation of possible sarcopenia by handgrip strength, the area under curve (AUC) on ROC curve analysis were 0.68 (95% CI 0.64–0.72), and 5-chair stand, the AUC on ROC were 0.55 (95% CI 0.51–0.60). The cut-off value for the GNRI discriminating those at possible sarcopenia by handgrip strength based on the Youden index was 91.5. Conclusions Our study suggests that the handgrip strength test of the AWGS 2019 sarcopenia consensus was a simple and useful tool to predict mortality in chronic hemodialysis patients. Furthermore, GNRI assessment can be a useful tool for screening before assessing possible sarcopenia when it is difficult to perform SARC-F to all patients.https://doi.org/10.1186/s12882-021-02566-wPossible sarcopeniaHandgrip strengthGNRIMortality |
| spellingShingle | Kenichi Kono Yoshifumi Moriyama Hiroki Yabe Ayaka Hara Takeki Ishida Tetsuya Yamada Yusuke Nishida Relationship between malnutrition and possible sarcopenia in the AWGS 2019 consensus affecting mortality in hemodialysis patients: a prospective cohort study BMC Nephrology Possible sarcopenia Handgrip strength GNRI Mortality |
| title | Relationship between malnutrition and possible sarcopenia in the AWGS 2019 consensus affecting mortality in hemodialysis patients: a prospective cohort study |
| title_full | Relationship between malnutrition and possible sarcopenia in the AWGS 2019 consensus affecting mortality in hemodialysis patients: a prospective cohort study |
| title_fullStr | Relationship between malnutrition and possible sarcopenia in the AWGS 2019 consensus affecting mortality in hemodialysis patients: a prospective cohort study |
| title_full_unstemmed | Relationship between malnutrition and possible sarcopenia in the AWGS 2019 consensus affecting mortality in hemodialysis patients: a prospective cohort study |
| title_short | Relationship between malnutrition and possible sarcopenia in the AWGS 2019 consensus affecting mortality in hemodialysis patients: a prospective cohort study |
| title_sort | relationship between malnutrition and possible sarcopenia in the awgs 2019 consensus affecting mortality in hemodialysis patients a prospective cohort study |
| topic | Possible sarcopenia Handgrip strength GNRI Mortality |
| url | https://doi.org/10.1186/s12882-021-02566-w |
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