Impact of Muscle Strength on Mortality in Individuals on Hemodialysis
Name: LETICIA DE PAIVA SOUZA KLIPPEL
Publication date: 05/12/2025
Examining board:
Name |
Role |
|---|---|
| ANDRESSA BOLSONI LOPES | Examinador Interno |
| CRISTIANE FERREIRA MORAES | Examinador Externo |
| LUCIANE BRESCIANI SALAROLI | Presidente |
Summary: Introduction: Chronic kidney disease (CKD) is
directly associated with an increase in mortality, with a rise of over 40% in
recent decades. It is well-established that individuals undergoing
hemodialysis typically experience diminished muscle strength, and this
impairment is linked to adverse outcomes, a worse prognosis, and an elevated
risk of mortality. Given that mortality rates are particularly high during
the first year of hemodialysis, handgrip strength (HGS) may serve as an
important indicator for early diagnosis and potentially offer a more accurate
prognosis. Objective: To assess the relationship between reduced muscle
strength and mortality in individuals undergoing hemodialysis in the Região
Metropolitana da Grande Vitória (RMGV). Methods: This is a retrospective
cohort study. The sociodemographic and clinical variables were taken from a
study of individuals on hemodialysis conducted in 2019. Mortality data was
obtained from death certificates from 2019 to 2022, recorded in the Mortality
Information System (SIM). HGS was classified according to the cutoff point of
<16 kg for women and <27 kg for men and into tertiles in the subsequent
study. Survival curves were drawn using the Kaplan Meier method. Models were
built using Cox regression. Analyses were carried out using R Software
(4.4.1), with a significance level of p<0.05. Preliminary results: 994
individuals were included and of these, 363 died. Reduced HGS increased the
risk of mortality by 49%, even after adjustment (p<0.001). When evaluated in
tertiles, FPP proved to be a better predictor of mortality, with a 1.81-fold
increase in the risk of death (p<0.001). Muscle mass indicators — Adductor
Pollicis Muscle Thickness (APMT) and Arm Muscle Area (AMA), did not show a
significant association with mortality.
