WCN23-0671 BASELINE CHARACTERISTICS OF PATIENTS ENROLLED IN THE DISCOVER CKD PROSPECTIVE STUDY

Abstract

Introduction: In observational studies, handgrip strength (HGS), a prognostic marker for healthy aging, has been associated with several chronic disease outcomes.The present systematic review and metaanalysis aimed to determine the quantitative relationship between HGS and the risk of all-cause mortality in patients with chronic kidney disease (CKD).Methods: Search PubMed, Embase, and Web of Science databases.The search was performed from inception to July 20, 2022.Cohort studies were included exploring the relationship between handgrip strength and the risk of all-cause mortality in patients with chronic kidney disease.Effect estimates and 95% confidence intervals were extracted from the studies to perform pooling.The quality of included studies was assessed using the Newcastle-Ottawa scale.We evaluated the overall certainty of evidence using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE).Results: This systematic review included 25 articles.A random-effects meta-analysis that included 16,106 patients with CKD showed that participants with lower HGS had an increased mortality risk of 96.1% compared to higher HGS (HR: 1.961; 95% CI 1.591-2.415)(GRADE: very low).Moreover, this association was independent of baseline mean age and follow-up time.In 2,044 patients with CKD, a fixed-effects modelbased meta-analysis showed that for each 1-unit increase in HGS, the risk of death in patients with CKD was reduced by 3.8% (HR: 0.962; 95% CI 0.948-0.976)(GRADE: moderate) (Figure 1).Two other studies reported results with lower HGS as the reference group, which we pooled separately because the studies did not provide sufficient data to convert the reference.The risk of all-cause mortality was 17.6% (HR: 0.824; 95% CI 0.654 to 1.038) lower in patients with CKD with higher HGS than those with lower HGS.Seven studies (2,044 participants) provided an association between each 1-unit increase in HGS and the risk of all-cause mortality.The meta-analysis results showed that each 1-unit increase in HGS was associated with a 3.8% (HR: 0.962; 95% CI 0.948-0.976)decrease in allcause mortality in patients with CKD.The evidence indicated moderate GRADE quality.

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