Grip Strength and Renal Disease: The New Essential Biomarker

In this article, we explore several insights related to grip strength and renal disease. Imagine if a simple handshake could offer powerful insights into renal disease.

This isn't just a metaphor. Grip strength has emerged as an indispensable data point for assessing and monitoring patients with complex health conditions, including renal disease.

The measurement of grip strength parameters in patients with renal disease provides a quick, non-invasive health gauge. It reflects muscle strength, often compromised in those with impaired kidney function.

Advanced chronic kidney disease (CKD) frequently leads to protein-energy wasting (PEW), causing significant muscle and fat loss, which is linked to higher illness and mortality rates.

Thus, diminished grip strength is a key biomarker for assessing renal disease risk and progression.

This document explains how grip strength can be used in clinical practice to assess risk, progression and prognosis in patients with renal disease.

Must-Know Metrics: Grip Strength and Renal Disease

Grip Strength Significance: Prediction of Kidney Disease-Related Mortality

For men with early-stage kidney disease, a grip strength below 37.5 lbs* signals poorer outcomes, while for women, the threshold is 15.4 lbs*. [Chang et al., 2011]

• Grip strength below 37.5 lbs* correlates to a 52.9% chance of survival for men with early-stage kidney disease
• Grip strength below 30.6 lbs* correlates to a 14.3% chance of survival for men with late-stage kidney disease
• Grip strength below 15.4 lbs* correlates with a 50% chance of survival for women with early-stage kidney disease and 45.5% survival rate in late-stage kidney disease

Grip Strength and Renal Disease: Prediction of Prognosis and System Burden

A grip strength of at least 43.0 lbs* for men and 35.5 lbs* for women who receive maintenance haemodialysis can be key in improving nutritional status and reducing hospital visits. [Silva et al., 2010]

*Note that all cut off points have been converted to GripAble-equivalent measurements for consistency

Grip Strength and Renal Disease in Practice

Clinical Application

Measure grip strength during routine check-ups to assess risk factors and track trends over time. For high-risk patients, consider providing a hand dynamometer for regular, at-home monitoring. Pay attention when grip strength drops below cut-off points or decreases by more than a quartile.

Patient Empowerment

Give patients access to their grip strength scores. This is a clear, tangible measure they can easily understand and actively improve with guidance. Unlike blood pressure, grip strength is relatable and empowering, enabling patients to track their progress as a key indicator of their independence.

Practical Considerations

Grip strength is an objective, non-invasive measure of patient condition and risk profiles. It helps guide treatment plans by assessing severity and identifying the most appropriate interventions.

Impact: Grip Strength and Renal Disease

• Reduce Utilization: better risk stratification and monitoring
• Improve Patient Satisfaction: where appropriate, give patients a quick, non-invasive tool to monitor disease status and response to treatment at home
• Support Risk Adjustment: quantify disease and treatment impact by using grip strength as an objective measure of muscle health

Citations

Cha, R, et al. Hand Grip and Leg Muscle Strength in Hemodialysis Patients and Its Determinants. Journal of Korean Medical Science, 36(11), 1-13. (2021)

Chang YT, et al. Handgrip strength is an independent predictor of renal outcomes in patients with chronic kidney diseases. Nephrol Dial Transplant. 2011 Nov;26(11):3588-95.

Cheng, Y, et al. Chronic kidney disease: prevalence and association with handgrip strength in a cross-sectional study. BMC Nephrology, 22(1) (2021)

Hwang, SH, et al. Handgrip Strength as a Predictor of All-Cause Mortality in Patients With Chronic Kidney Disease Undergoing Dialysis: A Meta-Analysis of Prospective Cohort Studies. In Journal of Renal Nutrition (Vol. 29, Issue 6, pp. 471-479). (2019).

Leal VO, et al. Use of handgrip strength in the assessment of the muscle function of chronic kidney disease patients on dialysis: a systematic review. Nephrology Dialysis Transplantation. 2010 Aug;26(4):1354-60.

Lopez-Bueno, R, et al. Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: a systematic review with dose-response meta-analysis. Aging Research Reviews 82 (2022): 101778.

Silva LF, et al. Handgrip strength as a simple indicator of possible malnutrition and inflammation in men and women on maintenance hemodialysis. J Ren Nutr. 2011 May;21(3):235-45.

Yoda M, et al. Poor muscle quality as a predictor of high mortality independent of diabetes in hemodialysis patients. Biomed Pharmacother. 2012 Jun;66(4):266-70.