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논문분류	춘계학술대회 초록집
제목	Volume Status Is Independently Associated with Muscle Strength in Maintenance Hemodialysis Patients
저자	Seunghye Lee
출판정보	2026; 2026(1):
키워드	hemodialysis, handgrip strength, volume status, bioelectrical impedance analysis
초록	Objectives: Muscle weakness is highly prevalent among patients receiving hemodialysis and is associated with adverse clinical outcomes. Although reduced skeletal muscle mass is a well-recognized determinant of muscle strength, the independent contribution of volume status to muscle strength remains unclear. We aimed to investigate the association between bioelectrical impedance analysis (BIA)–derived volume status and handgrip strength (HGS) in maintenance hemodialysis patients. Methods: This single-center cross-sectional study included maintenance hemodialysis patients who underwent BIA at GNUH between January and December 2024. Volume status was assessed using the extracellular water-to-total body water ratio (ECW/TBW) measured post-dialysis on the index date. Laboratory parameters were obtained on the same day as the BIA measurement. HGS was measured on the non-arteriovenous fistula arm, and low HGS was defined according to the Asian Working Group for Sarcopenia 2019 criteria. HGS and dialysis adequacy (Kt/V) were measured monthly over a six-month period centered on the index date (six measurements in total), and the mean values were used for analysis. Multivariable linear regression analyses were performed to evaluate the independent association between ECW/TBW and mean HGS after adjusting for age, sex, serum albumin, and skeletal muscle index (SMI). Results: A total of 54 patients were included. Patients with low HGS were older and had higher ECW/TBW and lower SMI compared with those with normal HGS. In multivariable analyses, higher ECW/TBW was independently associated with lower mean HGS across all models (Table 1). After full adjustment including SMI, ECW/TBW remained significantly associated with HGS (B=−190.7, 95% CI −317.9 to −63.4; p=0.004). SMI was positively associated with HGS (B=4.74, p<0.001). The fully adjusted model explained 64.4% of the variance in HGS (adjusted R²=0.644). Conclusion: Volume overload is independently associated with lower muscle strength in maintenance hemodialysis patients. These findings suggest that optimal volume control may help preserve muscle strength independent of skeletal muscle mass.
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