Comparison of appendicular lean mass indices for predicting physical performance in Korean hemodialysis patients: A cross-sectional study

Few studies have examined the optimal adjustment indices for predicting low muscle strength or physical performance in hemodialysis (HD) patients. Thus, the present study aimed to identify optimal adjustment indices for predicting strength and/or physical performance in HD patients. Our study was performed at an HD center (n = 84). Appendicular lean mass (ALM; kg) was calculated using dual-energy X-ray absorptiometry. ALM were adjusted to body weight, height(2) (Ht(2)), body surface area, or body mass index. Physical performance tests (sit-to-stand test performed 5 times test, sit-to-stand for 30 second test, 6-minute walk test, timed up and go test, gait speed, hand grip strength, average steps per day (AST), and short physical performance battery) were also evaluated. Participants with a below median value for each physical performance test were defined as the low group. The mean participant age was 55.6 ± 12.8 years; 44 (52.4%) were men. The univariate analysis revealed a significant difference in ALM/Ht(2) values between the low and normal physical performance group in all physical performance tests except short physical performance battery. The multivariate analysis revealed a significant difference in ALM/Ht(2) between the low and normal physical performance groups in hand grip strength, 5 times sit-to-stand test, sit-to-stand for 30-second test, and AST. In women on HD, most indices were not associated with physical performance or strength. We demonstrated that, in men on HD, ALM/Ht(2) may be the most valuable among various variables adjusted for ALM for predicting physical performance or strength.