RELATIONSHIP BETWEEN MUSCLE MASS AND MID-UPPER ARM CIRCUMFERENCE WITH HANDGRIP STRANGE IN CHRONIC KIDNEY DISEASE PATIENTS ON DIALYSIS

Abstract

Malnutrition is common in patients with chronic kidney disease (CKD) particularly renal failure. Assessment of the nutritional status of CKD patients is necessary to be evaluated periodically before falling into a state of protein energy wasting (PEW). The assessment of muscle reduction and mid-upper arm circumference may be one of the good indicators for malnutrition that reflects PEW. Other anthropometric measurement such as handgrip strength (HGS) is a simple and useful tool for continuously and systematically assessing muscle mass. In this study, we aimed to evaluate the nutritional statusin patients with renal failure on hemodialysis using MUAC parameters and muscle mass and to determine their correlation with HGS. This was an descriptive analytic study with cross sectional design conducted at Wahidin Sudirohusodo Hospital Hemodialysis Centre from July to August 2019. The study population included CKD patients aged 18-50 years, undergoing HD more than 1 month with a frequency of 2-3 times each week. Nutritional status was assessed based on MUAC using the MUAC tape, muscle mass based on bioelectrical impedance analysis (BIA) and HGS based on the HGS dynamometry level. Pearson, chi square and independent t-test were used for the statistical analysis of the data. Total of 55 subjects were evaluated, consisted of 29 (52.7 %) male and 26 (47.3 %) female subjects with an average age of 36.6 ± 8.1. Range of muscle mass was 33-75.8 kg, mean = 39; range of MUAC 18-33.5 cm, mean = 25.15 cm and range of HGS = 8-45 kg, mean = 21.07. There was a significant positive correlation between Handgrip Strength with Mid-Upper Arm Circumference and Muscle Mass (R = 0.723, p < 0.001 and R = 0.585, p < 0.001 respectively). A direct relationship existed between MUAC, muscle mass and HGS if when MUAC and muscle mass value decrease so does HGS value. HGS can be used as an assessment of nutritional status in patients with renal failure on hemodialysis.