Association of lean body mass with nutritional parameters and mortality in hemodialysis patients: A long-term follow-up clinical study

Abstract

Objective: This study aimed to evaluate the correlation between lean body mass (LBM) and nutritional status in hemodialysis (HD) patients to better predict their long-term prognosis. Methods: Anthropometric body measurements and biochemical parameters were recorded from 222 patients on maintenance hemodialysis (MHD) at the Shanghai Pudong Hospital Hemodialysis Center. LBM was calculated using the serum creatinine index (LBM-SCR), mid-arm muscle circumference (LBM-MAMC), and dominant-arm hand-grip strength (LBM-HGS). Patient mortality and hospitalization were observed after 24 months. Results: LBMs measured from LBM-SCR and LBM-MAMC were associated with sex, body mass index (BMI), serum albumin, and serum creatinine (SCR) ( p < 0.05). Through three methods of LBM evaluation, low LBM was shown to be associated with a higher mortality in patients undergoing HD ( p < 0.05). In addition, the rate of hospitalization among these patients was significantly increased ( p < 0.05). Performing multivariate regression analysis using mortality and hospitalization as the dependent variable, we found LBM-SCR and LBM-HGS are strongly associated with hospitalization and mortality in HD patients, indicating LBM is an important factor in prediction of outcomes in those patients. Conclusion: LBM is associated with nutritional parameters in HD patients, and LBM-SCR, HGS, and MAMC are simple approaches for accurately predicting the patient’s risk of hospitalization and/or death.