Association between handgrip strength and mortality in individuals undergoing hemodialysis: A retrospective cohort study.

Background and objectives: Handgrip strength offers a valuable method to detect changes and reduced muscle strength and frailty and can help improve prognosis by early diagnosis. Therefore, the aim of the study was to evaluate the association between reduced muscle strength and mortality in individuals undergoing hemodialysis.

Methods: Retrospective cohort study with 994 individuals. Sociodemographic, clinical, and lifestyle variables were obtained from a 2019 study. Mortality data were sourced from death certificates recorded from 2019 to 2022 in the Mortality Information System. Muscle strength was classified based on the following cut-off values: <27 kg for men and <16 kg for women. Survival curves were constructed using the Kaplan-Meier method and Cox Regression was used to evaluate the effect of handgrip strength and age on the time.

Results: More than 65 % of individuals in the sample show depleted strength, most of which were older adults (43.25 %, p < 0.001) and men (41.32 %, p = 0.008). Older adults with depleted strength showed a significantly higher number of observed deaths than expected ones (p < 0.001). After adjustment, HGS remained a significant predictor, associated with a 49 % increased risk of death (95 % CI: 1.16-1.91, p = 0.002). Having more than 11 years of formal education demonstrated a protective effect, reducing the risk of death by 1.6 times (95 % CI: 0.41-0.88, p = 0.009). Diabetes was found to be associated with almost a twofold increase in the risk of mortality (95 % CI: 1.54-2.49, p < 0.001).

Conclusions: The decrease in handgrip strength predicts mortality in individuals undergoing hemodialysis with the risk being higher among older adults, those with diabetes and individuals with fewer than 11 years of education.