Total protein or leucine intakes are not associated with handgrip strength in hemodialysis patients: A pilot study

Background & aims: Inadequate protein intake is associated with lean body mass (LBM) loss. However, it is unclear whether high protein diet and leucine intake are associated with handgrip strength (HGS), a validated marker of muscle function. This study aims to: i) assess the prevalence of patients with low HGS; and ii) verify if HGS is correlated with high protein diet and leucine consumption in hemodialysis patients.

Methods: This cross-sectional study analysed patients at two center hemodialysis (HD) clinic and sixty-two patients aged ∼39 years with length of time on HD ∼60 months undergoing HD was carried out. Body weight (kg), LBM (kg) and body fat mass (%) assessments were performed by dual-energy X-ray absorptiometry and height (m) through portable stadiometer. Body mass index (BMI) (kg/m²) was calculated using the body weight and height. HGS (kg) was measured using a hydraulic dynamometer. Fisher's exact test, Chi-square, Pearson's correlation, and logistic regression were done to test the hypothesis.

Results: Out of 62 patients, 47 (75.8%) presented low HGS. In addition, no correlation was found between protein intake (if in percentage or g/kg/d) and HGS (r = 0.07, p = 0.58; r = -0.04, p = 0.70, respectively). Although there is a low correlation among leucine intake (g/d) and HGS (r = 0.39, p = 0.01), low HGS was not associated with leucine intake in the crude model (OR: 0.86 95%CI(0.60-1.24) p = 0.441), nor after adjustment for age, sex and BMI (OR: 0.84 95%CI(0.56-1.26), p = 0.422).

Conclusions: Approximately 75% of patients undergoing hemodialysis presented low HGS. Additionally, neither a high protein diet nor leucine intake was associated with the HGS values.