Associação da composição corporal com a força muscular e atividades diárias em pacientes com doença renal crônica mantidos em hemodiálise.

Abstract

We aimed to compare lean tissue index between patients with low and normal muscle strength in order to determine a cut-off to classify low muscle mass in order to look for variables associated with low muscle mass among end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). We studied 245 ESRD patients on HD in the only two dialysis centers located in the north region of Ceará state, Brazil, in April 2017. Demographic, clinical, laboratory and anthropometric measurements were collected. Patients’ functional ability was assessed by the Brazilian version of the Stanford Health Assessment Questionnaire Disability Index. Bioimpedance analysis and handgrip test were, respectively, used to evaluate lean tissue index and muscle strength. We classified low muscle mass according to muscle strength, and compared variables between patients with normal and low muscle mass. Variables that differed in the comparison were analyzed in a model of logistic regression to detect independent predictors of low muscle mass.According to a cut-off of less than or equal to 15 kg/m 2 of lean tissue index to classify low muscle mass, we found a prevalence of 41.2% of low muscle mass. Patients with low muscle mass presented with higher prevalence of functional disability. In multivariate logistic regression (considering low muscle mass as a dependent variable), age (older), female gender, creatinine level, fat tissue index and abnormal waist to hip ratio were found to be independent predictors of low muscle mass. Older patients, women, patients with low creatinine, with high fat tissue index and with abnormal waist to hip ratio must be seen at risk of low muscle mass. Dietary approach, stimulus to resistance exercise and the use of androgens should be tried in this group of patients.