Banca de DEFESA: KAROLINE BÁRBARA DA SILVA OLIVEIRA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : KAROLINE BÁRBARA DA SILVA OLIVEIRA
DATE: 25/04/2023
TIME: 09:00
LOCAL: google meet
TITLE:

Handgrip strength and corrected arm muscle area as risk factors for clinical outcomes and mortality in patients with chronic kidney disease on hemodialysis

KEY WORDS:

Kidney Disease, Chronic. Hemodialysis. Hospitalization. Mortality. Cardiovascular diseases.

PAGES: 35
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

INTRODUCTION: Chronic kidney disease (CKD) negatively affects muscle health
with consequent increase in frailty. Especially in patients undergoing
hemodialysis (HD), peculiar factors of the pathology and the dialysis process favor the
decline in nutritional status, greater fragility and risk of falls and fractures in these
patients, negatively impacting quality of life and contributing to a worse
prognosis. OBJECTIVES: To investigate the association of muscle strength and muscle mass
reduced in patients with CKD on HD and their impact as a risk factor for
hospitalizations, cardiovascular events, and mortality. MATERIAL AND METHODS:
This is a prospective cohort, carried out with 300 patients between 18 and 80 years of age, in
Chronic HD. Muscle strength was measured by handgrip strength (HGS) and
muscle mass by the equation estimating the corrected arm muscle area (AMBc).
Patients were classified as reduced HGS as HGS<26kg for men and
<16kg for women. Those were classified with muscle depletion by AMBc
who presented values ≤15th percentile according to sex and age group. The patients were
followed for a minimum period of 9 months to observe the incidence of
clinical outcomes investigated. For analysis of the association between reduced HGS and AMBc
and clinical outcomes, the Kaplan-Meier survival curve and the logrank test were used. A multivariate analysis was also performed using the regression model of
Cox proportional hazards presented as hazard ratio (RR) at intervals of
95% confidence (95% CI) and considered significant when p<0.05.
RESULTS: Reduced FMF was significantly associated with Mass Index
Body (BMI) and type of vascular access (p=<0.05). The reduced AMBc was also
associated with BMI (p=0.015), in addition to longer HD time (p<0.001). According to analysis
of regression, it was evidenced that HGS and reduced AMBc presented themselves as factors
of significant risk for the incidence of hospitalizations (p<0.001) and events
cardiovascular (p=0.025). The reduced AMBc is still strongly associated with
increased relative risk for mortality (p=0.020). CONCLUSION: Patients with
CKD on HD that showed reduced muscle strength and muscle mass measured by
HGS and AMBc have a higher risk for the incidence of hospitalizations, events
cardiovascular and mortality when compared to patients with HGS and AMBc
Normal.

BANKING MEMBERS:
Interno(a) - 4364569 - FABIANA ANDREA MOURA
Interno(a) - 1791653 - FLAVIO TELES DE FARIAS FILHO
Interno(a) - 3621153 - JULIANA CELIA DE FARIAS SANTOS
Presidente - 2154281 - RODRIGO PEIXOTO CAMPOS
Externo(a) ao Programa - 1042196 - SAMARA BOMFIM GOMES CAMPOS