Validation of Handgrip Strength as a Nutritional Assessment Tool for Hemodialysis Patients in Dr. Sardjito Hospital, Indonesia

Background and Objective: Handgrip strength (HGS) is used for continuous and systematic assessment of muscle mass related to nutritional status in hemodialysis (HD) patients. This study aimed to evaluate the ability of the HGS test to assess the nutritional status of hemodialysis patients. Materials and Methods: Data were collected from 104 patients with chronic kidney disease (CKD) undergoing routine HD in Dr. Sardjito Hospital, Yogyakarta, Indonesia. Patients were selected for the study using purposive sampling. All subjects were assessed using the HGS test and then compared using the subjective global assessment (SGA), dialysis malnutrition score (DMS), nutritional risk screening 2002 (NRS 2002) and simple nutrition screening tool (SNST). Correlation tests were conducted to determine associations between HGS and SGA, DMS, NRS 2002, SNST, body mass index and mid-upper arm circumference (MUAC). Results: The sensitivity of HGS for the study of male participants was the highest when compared to SGA (76.9%), but it had low specificity, accuracy, positive predictive value and area under the curve. HGS performed poorly when compared to other tools. For women in the study, HGS had highest specificity when compared to SGA (79.2%), but it had low sensitivity, positive and negative predictive values and area under the curve. When compared to other tools, HGS gave an even lower result. HGS had a negative correlation with the other four nutritional assessment tools, but it had a positive correlation with MUAC. Conclusion: The HGS test appeared to be an inaccurate assessment of nutritional status in male and female CKD patients undergoing hemodialysis.