Pediatric Nephrology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
J Ren Nutr. 2018 Jul;28(4):265-269. doi: 10.1053/j.jrn.2017.12.007. Epub 2018 May 3.
Muscle status assessment is crucial for diagnosis of protein energy wasting PEW/cachexia in chronic kidney disease (CKD) population. Hand grip strength (HGS) has been used in muscle power assessment in adult CKD. However, no data is available about its usefulness in children with CKD. Hence, we aimed to study the reliability of HGS in reflecting the muscle power and thus, nutritional status in children with CKD.
In this Observational cross sectional study we enrolled 73 CKD children; 45 had end stage kidney disease (ESKD) on hemodialysis (HD) and 28 had CKD but not on dialysis yet. Assessment of children's nutritional status was done through biochemical variables (serum albumin and serum cholesterol) and anthropometric measures (height and BMI). Body composition monitor (BCM) device was used for lean tissue mass (LTM) assessment whilst muscle power was tested by HGS tool.
The study showed that 69.8% of CKD patients had HGS values below 10th percentile for age and sex. Moreover, HGS was observed to be more affected in CRI patients and those with non - glomerular causes. HGS was also found to be positively correlated to height but not to lean tissue mass or serum albumin.
HGS tool can be used as a reliable bedside tool for nutritional assessment in children with CKD.
肌肉状况评估对于诊断慢性肾脏病（CKD）患者的蛋白质能量消耗（PEW/恶病质）至关重要。握力（HGS）已用于成人 CKD 患者的肌肉力量评估。然而，尚无关于其在 CKD 儿童中应用的相关数据。因此，我们旨在研究 HGS 在反映肌肉力量和儿童 CKD 营养状况方面的可靠性。
在这项观察性横断面研究中，我们纳入了 73 名 CKD 儿童；其中 45 名患有终末期肾病（ESKD）并接受血液透析（HD）治疗，28 名患有 CKD 但尚未接受透析治疗。通过生化变量（血清白蛋白和血清胆固醇）和人体测量学指标（身高和 BMI）评估儿童的营养状况。使用身体成分监测仪（BCM）设备评估瘦组织量（LTM），同时使用 HGS 工具测试肌肉力量。
研究表明，69.8%的 CKD 患者的 HGS 值低于年龄和性别对应的第 10 百分位数。此外，CRI 患者和非肾小球病因患者的 HGS 受影响更大。HGS 还与身高呈正相关，但与瘦组织量或血清白蛋白无关。
HGS 工具可作为 CKD 儿童营养评估的可靠床边工具。
