Diagnostic accuracy of handgrip strength in the assessment of malnutrition in hemodialyzed patients
2013
Garcia, Monique Ferreira | Wazlawik, Elisabeth | Moreno, Yara Maria Franco | Führ, Letícia Maria | González-Chica, David Alejandro
BACKGROUND & AIMS: Parameters with diagnostic accuracy to malnutrition assessment may be a challenge for patients in hemodialysis (HD). Thus, the objective of this study was to verify the accuracy and cutoff of handgrip strength (HGS) in nutritional assessment. METHODS: Validation study of diagnostic tests. Cutoff to malnutrition was investigated by the ROC curves, using as reference standard the subjective global assessment (SGA), nutritional risk screening 2002 (NRS 2002) and malnutrition-inflammation score (MIS). The association of HGS with: phase angle (PA), body mass index, percentage of fat mass, fat-free mass (FFM), was verified by multiple linear regression, P < 0.05. RESULTS: 138 patients were evaluated (85 men), mean 55.4 ± 15.2 years. The area under the curve of the HGS showed moderate accuracy in women (SGA = 0.818; MIS = 0.834; NRS 2002 = 0.882) and low accuracy in men (SGA = 0.646; MIS = 0.606; NRS 2002 = 0.620). Cutoff values of HGS for the diagnosis of malnutrition, according to the reference standard were: <18 kg for women and <28.5 kg for men. The women classified as malnourished by HGS had lower values of PA (β = −1.00), FFM (β = −3.15) and MAC (β = −2.80), while malnourished men had lower values of FFM (β = −4.35), MAC (β = −1.71) and MAMC (β = −1.28). CONCLUSION: HGS was accurate in the diagnosis of malnutrition in women in HD, and provided consistent results of association with most of the nutritional parameters, for both genders.
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