Patients with chronic kidney disease will have physical weakness, weight loss, muscle mass loss, and in severe cases, physical activity will be limited. The physical weakness of patients with chronic kidney disease is mainly caused by 2 types of factors. Category 1 is a disease-related factor, for example, renal anemia. The other category is the therapeutic factor, for example, the effects of dialysis treatment. Weakness accelerates the progression of chronic kidney disease and increases the risk of death. Recently, American scholars have summarized 6 methods for assessing the degree of physical weakness, and we will introduce the relevant points for you now.
Relevant studies have shown that the degree of physical weakness is an important indicator to assess the progression of the disease in patients with chronic kidney disease. For example, studies have found that the better the patient's grip strength, cardiopulmonary function, endurance, etc., the lower the risk of dialysis. Conversely, patients with chronic kidney disease with sarcopenia increase the risk of dialysis by a factor of 2. In diabetic nephropathy, the risk of dialysis required by frail people who progress to end-stage renal disease is significantly increased. For dialysis patients, people with poor muscle strength have a 1.7 to 2.3 times higher risk of death than those with normal muscle strength. Therefore, scholars suggest that patients in the early stages of chronic kidney disease should predict the rate of progression and associated risks of their own disease through assessment of physical weakness.
The degree of physical weakness can be assessed in 6 ways, and patients themselves can also do the initial test at home and then find a doctor for professional evaluation. The first method is muscle strength testing, the main method of upper limb strength testing is grip strength assessment, the main method of lower limb strength testing is knee equidistant strength test, and the simple method is sitting testing. The normal range of grip strength, 43.5 to 49.5 kg for men and 27 to 31 kg for women, requires vigilance if grip strength is severely reduced. The sit-up detection method is to sit on a chair and repeat 5 times of standing and sitting actions, if the completion time is less than 11.1 seconds, the score is 4, more than 16.7 seconds, the score is 1, more than 60 seconds or can not be completed, the score is 0.
The second method of physical frailty assessment is the walking speed test, the patient needs to walk a distance of 4 meters as soon as possible on a flat ground, after completing multiple times, according to the average of the 2 best results, less than 4.8 seconds, the score is 4, 4.8 to 6.2 seconds, the score is 3, 6.3 to 8.7 seconds, the score is 2, more than 8.7 seconds, the score is 1, can not be completed, the score is 0. The lower the score, the more severe the physical weakness. Recording score changes at different stages can predict the progression of the disease. The score drops more quickly, indicating that kidney function is deteriorating.
The third method for assessing the degree of physical weakness is the balance test, which is divided into two situations: static and dynamic. Static detection, by standing time score, standing with both feet together, maintaining time for more than 10 seconds, with a score of 1, less than 10 seconds, a score of 0. With the feet staggered, the back toes resting against the front heel, balance standing for more than 10 seconds, with a score of 2, maintaining for 3 to 9 seconds, with a fraction of 1, less than 3 seconds, and a fraction of 0. Patients can follow these tips, understand the connotations, and with the help of others, conduct self-tests, find abnormalities, and then do professional tests.
The fourth method of physical weakness assessment is muscle strength testing, professional testing requires dual-energy X-ray examination and bioimpedance analysis, the patient's own test, can measure the circumference of the muscles in the middle of the arm and the calf muscles, if there is a significant shortening, it indicates muscle strength loss. In addition, changes in serum creatinine and urinary creatinine levels can also assess muscle mass.
The fifth method for assessing physical weakness is the test of motor ability, the most effective method is the cardiopulmonary exercise test, and in combination with the electrocardiogram, the risk of arrhythmias and myocardial ischemia in exercise is assessed. A simple self-test method is a 6-minute or 2-minute walking distance change. The sixth method is a comprehensive screening, through professional testing, comprehensive assessment. Studies have shown that anemia is a common complication of chronic kidney disease, and more than 50% of our compatriots with chronic kidney disease are anemia, and anemia is an important factor causing physical weakness. When kidney function is impaired, the renal secretion of erythropoietin is reduced, affecting the hematopoietic function of the bone marrow, resulting in anemia. Therefore, by doing regular blood tests, timely detection of changes in the relevant indicators of anemia is also a reliable way to predict the degree of physical weakness.
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