PD395 - COMPARISON OF AGE- AND SEX-STANDARDIZED HANDGRIP STRENGTH AND EWGSOP2 CRITERIA IN HEMODIALYSIS PATIENTS

PD395

COMPARISON OF AGE- AND SEX-STANDARDIZED HANDGRIP STRENGTH AND EWGSOP2 CRITERIA IN HEMODIALYSIS PATIENTS

O. Valderrama^1,*, R. Broce², R. Ávila², M. Batista², M. Vergara², A. Sáez², V. Rodríguez², A. Gómez², E. Montero², I. Barría², M. Montenegro²

¹Nutritional Support Committee, ²Department of Nutrition and Dietetics, Hospital Santo Tomás, Panama, Panama

Rationale: Accurate identification of muscle weakness is essential in hemodialysis patients. Fixed cut-offs such as those proposed by EWGSOP2, developed for older populations, may not fully account for age- and sex-related variability. We aimed to compare the detection of low muscle strength using standardized handgrip strength (HGS_Z) versus EWGSOP2 criteria.

Methods: We conducted a cross-sectional study of adult patients on hemodialysis (January and July 2025). Muscle strength was assessed using handgrip dynamometry. Low muscle strength was defined using age- and sex-adjusted z-scores (HGS_Z ≤1.65) and compared with EWGSOP2 cut-offs (<27kg in men and <16 kg in women). Patients <20 years were excluded due to lack of reference values for standardized HGS. Agreement between definitions was assessed using the McNemar test. EWGSOP2 performance was evaluated against HGS_Z (sensitivity, specificity), with age-stratified analyses (<65 vs ≥65 years).

Results: A total of 100 patients were included, predominately men (63.8%), with a mean age of 44.8 ± 14.5 years and median time on hemodialysis of 24 months (IQR 12–72). Low muscle strength was identified in 57.0% using HGS_Z versus 43.0% with EWGSOP2 (p=0.006). Sensitivity and specificity of EWGSOP2 were 73.7% and 97.7%, respectively.

Age-stratified analyses showed marked differences. In patients ≥65 years, EWGSOP2 had 100% sensitivity and 90% specificity. In those <65 years, EWGSOP2 missed 15 cases, with sensitivity 72.7% and specificity 100%.

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Conclusion: Age- and sex-standardized handgrip strength identifies a higher proportion of patients with muscle weakness compared to EWGSOP2 criteria. While EWGSOP2 provides a standardized framework for sarcopenia diagnosis, its fixed cut-offs may underestimate muscle impairment in younger or clinically distinct populations such as hemodialysis patients.

Disclosure of Interest: None declared