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Open AccessArticle

Composite Uremic Load and Physical Performance in Hemodialysis Patients: A Cross-Sectional Study

1
Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Ghent, Belgium
2
Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, B-2650 Antwerp, Belgium
3
Department of Nephrology, University Hospitals Leuven, B-3001 Leuven, Belgium
4
Department of Internal Medicine, Renal Division, Ghent University Hospital, B-9000 Ghent, Belgium
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(2), 135; https://doi.org/10.3390/toxins12020135
Received: 5 December 2019 / Revised: 19 February 2020 / Accepted: 21 February 2020 / Published: 22 February 2020
(This article belongs to the Section Uremic Toxins)
Impaired physical performance is common in patients on hemodialysis (HD) and is associated with poor prognosis. A patient relevant marker of adequacy of dialysis is lacking. Previous studies evaluated uremic toxicity by assessing the impact of different uremic toxins separately. However, such an approach is most likely not reflective of true uremic toxicity. Therefore, this cross-sectional study aimed to examine if the uremic syndrome, estimated as one composite of different uremic toxins (facilitated by ridge regression method) to reflect the kinetic behavior during dialysis, is associated with physical performance in patients on HD. Levels of p-cresyl glucuronide and sulfate, indole-acetic acid, indoxyl sulfate, uric acid, hippuric acid, and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid were assessed and associated by ridge regression to muscle strength, functional exercise capacity, and measures of balance and coordination. 75 HD patients were included (mean age 68 years, 57% male). The composite of different uremic toxins (i.e., uremic load) explained 22% of the variance in handgrip strength. Although there was an association between full body muscle strength and the composite uremic load independent of nutritional status, age and gender, the predictive power of composite uremic load for muscle weakness is limited. Single uremic toxins as well as composite uremic load were not associated with exercise capacity, coordination, and balance, indicating that the degree of uremia does not predict physical performance in patients on HD. View Full-Text
Keywords: end-stage renal disease; uremic toxins; muscle strength; exercise capacity; coordination and balance; physical performance; hemodialysis end-stage renal disease; uremic toxins; muscle strength; exercise capacity; coordination and balance; physical performance; hemodialysis
MDPI and ACS Style

Vanden Wyngaert, K.; Van Craenenbroeck, A.H.; Holvoet, E.; Calders, P.; Van Biesen, W.; Eloot, S. Composite Uremic Load and Physical Performance in Hemodialysis Patients: A Cross-Sectional Study. Toxins 2020, 12, 135.

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