Impacto da força muscular na mortalidade em indivíduos em hemodiálise
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Data
2025-12-05
Autores
Klippel, Leticia de Paiva Souza
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Universidade Federal do Espírito Santo
Resumo
Introduction: Chronic kidney disease (CKD) is directly associated with an increase in mortality, with a rise of over 40% in recent decades. It is well-established that individuals undergoing hemodialysis typically experience diminished muscle strength, and this impairment is linked to adverse outcomes, a worse prognosis, and an elevated risk of mortality. Given that mortality rates are particularly high during the first year of hemodialysis, handgrip strength (HGS) may serve as an important indicator for early diagnosis and potentially offer a more accurate prognosis. Objective: To assess the relationship between reduced muscle strength and mortality in individuals undergoing hemodialysis in the Região Metropolitana da Grande Vitória (RMGV). Methods: This is a retrospective cohort study. The sociodemographic and clinical variables were taken from a study of individuals on hemodialysis conducted in 2019. Mortality data was obtained from death certificates from 2019 to 2022, recorded in the Mortality Information System (SIM). HGS was classified according to the cutoff point of <16kg for women and <27kg for men and into tertiles in the subsequent study. Survival curves were drawn using the Kaplan Meier method. Models were built using Cox regression. Analyses were carried out using R Software (4.4.1), with a significance level of p<0.05. Preliminary results: 994 individuals were included and of these, 363 died. Reduced HGS increased the risk of mortality by 49%, even after adjustment (p<0.001). When evaluated in tertiles, FPM proved to be a better predictor of mortality, with a 1.81-fold increase in the risk of death (p<0.001). Muscle mass indicators — Adductor Pollicis Muscle Thickness (APMT) and Arm Muscle Area (AMA), did not show a significant association with mortality.
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Doença Renal Crônica , Força muscular , Força de preensão manual , Hemodiálise , Mortalidade , Sobrevivência , Chronic Kidney Disease , Muscle strength , Handgrip strength , Hemodialysis , Mortality , Survival