The reduction in handgrip strength is a predictor of increased length of hospital stay, functional limitation, reduced quality of life and mortality.

to evaluate the agreement between the three reference standards for handgrip strength in elderly patients with chronic kidney disease undergoing hemodialysis.

Cross-sectional and analytical study, with participants of both gender, over 18 years of age, on hemodialysis for more than three months in the nephrology unit of the Hospital Regional de Taguatinga, between June 2019 and April 2019. Data on dialysis time, presence of diabetes, hypertension and cause of kidney disease were obtained through Trackcare® electronic records. Handgrip strength was measured on the dominant limb or contralateral to the presence of arteriovenous fistula using a Jamar® hydraulic dynamometer. The three reference standards used for the diagnosis of low handgrip strength were: 1) European Working Group on Sarcopenia in Older People (EWGSOP 2019) considering cutoff points for men < 27 kgf and for women < 16 kgf; 2) Reference standard for the american population according to the study by Wang et al. (2018), considering low handgrip strength, percentile values ​​lower than 10, according to gender and age; 3) Reference standard for the Brazilian population according to the study by Schlussel et al. (2008), also considering low handgrip strength values ​​lower than 10, according to gender and age. The statistical program Statistical Package for the Social Sciences (SPSS) version 26.0 used for statistical analyses. The Kolmogorov Smirnov test was used to assess the normality of the variables. For agreement analysis, the kappa coefficient was used. The statistical significance considered was p<0.05.

The sample consisted of 112 participants, mean age 68.45±6.52 years old, dialysis time 22.39±46.45 months, 67.00% (n=75) men, 33.00% (n=37) women. The most common cause of kidney disease was diabetic nephropathy in 45.53% (n=51) subjects. The body mass index of all participants ranged from 15.34 to 37.40 kg/m2. The diagnosis of reduced handgrip strength in the sample, according to EWGSOP (2019), Wang et al. (2018) and Schlussel et al. (2008) was 66.10%, 37.50% e 63.40%, respectively. The reference standard by Wang et al. (2018) and Schlussel et al. (2008) showed moderate agreement (к = 0.448, p<0.001). The concordance between EWGSOP (2019) and Wang et al. (2018) was also moderate (к = 0.471, p<0.001). Between EWGSOP (2019) and the study by Schlussel et al. (2008) substantial agreement was observed (к = 0.785, p<0.001).

EWGSOP (2019) and Schlussel et al. (2008) showed good agreement for diagnosing reduced handgrip strength in elderly patients undergoing hemodialysis.

the reduction in handgrip strength has a negative impact on elderly patients with chronic kidney disease. It's a tool not influenced by volume changes and is necessary to diagnose sarcopenia in this population.