The following is the summary of “Synergistic deterioration of prognosis associated with decreased grip strength and hyporesponse to erythropoiesis-stimulating agents in patients undergoing hemodialysis” published in the October 2022 issue of Renal failure by Kobayashi, et al.

Researchers analyzed how low handgrip strength (HGS) and erythropoietin (EPO) hyporesponsiveness interact to determine a hemodialysis patient’s prognosis (HD). Between January and March 2015, we enrolled a total of 182 patients with CKD Stage 5 receiving HD at our dialysis clinic. Subjects were to be younger than ≥20 years old and have received HD for at least  ≧3 months before enrolment. 7  epoetin-β pegol patients were not included in the analysis. ERI and HGS were initially assessed. 

Patients were divided into groups based on their height, weight, and height-to-body-mass ratio (HGS; 28 kg for males, 18 kg for women). The ERI was 9.44 (U/kg/week/g/dL). After that, we followed them for 2 years for the composite endpoint (deaths or CVD). Patients’ ages ranged from 34 to 92 years old, and 175 of them total. There were 57 occurrences recorded over the 24-month monitoring period, including 14 deaths and 43 cases of CVD. Endpoints were more common in those with high ERI and low HGS than in those with low ERI and high HGS. 

The high ERI/low HGS group had the highest risk among the four categories defined by ERI and HGS values (HR: 4.20, 95% CI: 2.12-8.33). The combination of EPO hyporesponsiveness and low HGS was found to be a powerful predictor of poor outcomes, with the synergistic effects of the two factors having greater predictive potential than either factor alone.