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Background: Chronic kidney disease (CKD) patients commonly report muscle weakness and fatigue. Losing muscle mass increases mortality. Accordingly, we aimed to determine the main factors associated with loss of muscle mass and muscle weakness. Methods: Anthropometric measurements were made in CKD patients attending a specialised clinic, along with hand grip strength (HGS), pinch strength (PS) and body composition (muscle mass and fat mass), using segmental bioimpedance assessment. Results: We reviewed the results of 161 CKD patients; 105 male (65.2%), mean (SD) age 70.3 (15) years, body mass index (BMI) 28.8 (6.7) kg m−2. In multivariable models, both HGS and PS were independently negatively associated with age [standardised β (St β) = 0.35; 95% confidence limits (CL) = −0.32 to −0.14; St β = 0.38; 95% CL = −0.65 to −0.02; P < 0.001, respectively] and positively with appendicular muscle in the arm tested [St β = 0.34; 95% CL = 2.5–6.3; St β = 0.24; 95% CL = 0.17–0.98; P < 0.001 and P = 0.006, respectively]. In addition, HGS was associated with male gender (St β = 0.19; 95% CL = 0.7–7.5; P = 0.019] and negatively with percentage body fat (St β = 0.22; 95% CL = −0.36 to −0.07; P = 0.003]. There were 47 (29.2%) Asian patients who had lower total skeletal muscle mass/height ratio and appendicular muscle mass/BMI ratio compared to other ethnicities [9.6 (1.8) versus 10.5 (1.6) kg m−2, P < 0.01; 0.73 (0.23) versus 0.83 (0.33) m2; P < 0.01). Conclusions: In CKD patients, we found that muscle weakness measured by HGS and PS was associated with increasing age and loss of appendicular muscle mass. HGS was also weaker with increasing fat mass and female gender, whereas PS was weaker in patients of Asian ethnicity. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) patients are at increased risk of sarcopenic muscle wasting, with increased mortality risk. Simple screening tests are required to detect sarcopenia to allow for interventional therapies. We wished to compare anthropometric and multifrequency bioimpedance (MFBIA) measurements of arm composition and muscle strength. We measured segmental MFBIA, mid arm upper circumference (MUAC) and triceps skin fold thickness (TSF), hand grip strength (HGS) and pinch strength (PS) in CKD patients attending out-patient review. We reviewed 146 patients; 94 male (64.4%), 93 (63.7%) diabetic, mean age 70.5 ± 15 years, weight 77.6 ± 17.1 kg, with a mean HGS of 25.2 ± 10.4, and PS 5.0 ± 1.9 kg. HGS and PS were correlated (r = 0.63, p < 0.001). Male patients had greater HGS and PS (28.3 ± 10.1 vs 19.7 ± 7.0 kg; and 5.3 ± 2.0 vs 4.3 ± 1.1 kg, p < 0.05) with greater arm muscle (3.2 ± 0.7 vs 2.4 ± 0.7 kg, p < 0.05) and less arm fat (1.8 ± 1.3 vs 2.9 ± 1.8 kg, p < 0.05), whereas there was no difference in anthropometric measurements of mid upper arm muscle or fat area. Whereas both HGS and PS correlated positively with MFBIA arm lean mass (r = 0.55, r = 0.37, p < 0.001) and negatively for arm fat mass (r = −0.4, p < 0.001, r = −0.32, p = 0.001) respectively, there were no correlations with anthropometric derived estimates of upper arm muscle or fat. In CKD patients, segmental MFBIA measurements of the arm, but not those derived from anthropometric measurements demonstrate gender differences and correlate with arm muscle strength, whereas there were no such correlations with anthropometric estimates of upper arm muscle or fat. [ABSTRACT FROM AUTHOR]