Handgrip strength linked to death risk among CKD patients on dialysis

Handgrip strength (HGS) may be an easy and useful predictor of mortality among chronic kidney disease (CKD) patients receiving dialysis, reports a recent meta-analysis.

Accessing the databases of PubMed and Embase, researchers retrieved nine prospective cohort studies for inclusion in the analysis. The resulting pooled sample consisted of 2,775 CKD patients. Only reports that measured absolute or relative HGS as the sole predictor of clinical outcomes were eligible. The Newcastle-Ottawa Scale (NOS) was used to assess methodological quality.

Ten distinct datasets were available from the nine included studies. The first meta-analysis included six of these sets (n=1,996) and found that patients who had weak HGS were almost twice as likely to die than their stronger counterparts (risk ratio [RR], 1.88, 95 percent confidence intervals [CI], 1.51–2.33; p<0.001).

The effect of low HGS on mortality risk appeared to be slightly greater when assessments were performed before dialysis initiation (RR, 1.89, 95 percent CI, 1.42–2.52).

Three studies (n=779) allowed estimation of all-cause death risk according to a continuous HGS variable. Each kilogram increase in HGS led to a significant 5-percent reduction in the associated risk (RR, 0.95, 95 percent CI, 0.93–0.97; p<0.001).

Egger’s regression test found no evidence of publication bias, both for analyses of HGS as a categorical (p=0.968) and continuous (p=0.755) variable. All included studies scored at least 7 stars in the NOS, and all outcomes were measured using reliable methods. Results were robust to sensitivity analyses.