Faculty of Sport, University of Ljubljana, Gortanova 22, 1000 Ljubljana, Slovenia.
Department of Nephrology, University Medical Centre Ljubljana, Zaloška 2, 1525 Ljubljana, Slovenia.
Clin Nutr. 2018 Jun;37(3):870-877. doi: 10.1016/j.clnu.2017.03.008. Epub 2017 Mar 16.
BACKGROUND & AIMS: Physical performance deficits in kidney failure predict mortality and quality of life. We aimed to quantify deficits in multiple motor abilities, investigate associations of lean and fat tissue content with test results and analyzed performance of sarcopenic individuals with adipose tissue excess.
Ninety hemodialysis patients and 140 healthy controls performed 6-minute walk test, gait speed measurement, sit-to-stand and time up and go tests, upper extremity handgrip and tapping tests, Stork balance and forward bend flexibility tests. Human Activity Profile questionnaire was used to assess habitual activity. Body composition was measured by bioimpedance analysis.
Relative performance deficit of dialysis patients in age, sex, height and comorbidity adjusted estimated marginal means was largest for balance and flexibility (-52 and -33%), followed by lower extremity deficits in sit-to-stand, time up and go and 6-minute walk tests (-29, -19 and -15%, respectively), p < 0.05 for all comparisons. Upper extremity performance was less affected. Lean tissue index associated significantly positively with five and fat tissue index associated significantly negatively with two out of nine tests. Sarcopenic overweight and obese individuals exhibited significant deficits mainly in lower extremity tests with worse composite lower extremity score when compared to other categories of body composition.
Patients with hemodialysis treated kidney failure have largest functional deficits in balance, flexibility and lower extremity functions. Lean and fat mass associate oppositely with physical performance measures and individuals at unfavorable extremes of these indices express significantly impaired lower extremity functions.
肾衰竭患者的身体机能缺陷可预测死亡率和生活质量。我们旨在量化多种运动能力的缺陷，研究瘦组织和脂肪组织含量与测试结果的相关性，并分析有脂肪组织过剩的肌少症个体的表现。
90 名血液透析患者和 140 名健康对照者进行了 6 分钟步行测试、步态速度测量、坐站和起身行走测试、上肢握力和敲击测试、圣多克平衡和前屈柔韧性测试。使用人体活动概况问卷评估习惯性活动。通过生物阻抗分析测量身体成分。
在年龄、性别、身高和合并症调整后的估计边际平均值中，透析患者的相对表现缺陷在平衡和柔韧性方面最大（分别为-52%和-33%），其次是坐站、起身行走和 6 分钟步行测试的下肢缺陷（分别为-29%、-19%和-15%），所有比较均具有统计学意义（p<0.05）。上肢表现受影响较小。瘦组织指数与九项测试中的五项呈显著正相关，脂肪组织指数与两项呈显著负相关。与其他身体成分类别相比，肌少症超重和肥胖个体在下肢测试中表现出明显的缺陷，复合下肢评分较差。
接受血液透析治疗的肾衰竭患者在平衡、柔韧性和下肢功能方面存在最大的功能缺陷。瘦组织和脂肪量与身体机能测量呈相反的关系，这些指数处于不利极端的个体下肢功能明显受损。
