Handgrip strength : A tool of nutritional assessment , The possible effect of high protein diet and L-carnitine in hemodialysis patients / Sanaa Abdelrasoul Khalil ; Supervised Tareq Hussein Alshabony , Noha Adel Ibrahim

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Malnutrition is a common problem in patients with end stage renal disease (ESRD) undergoing hemodialysis that is associated with increased morbidity and mortality. There are several clinical, nutritional, and biochemical parameters that may be indicative of PEW in patients using hemodialysis (HD). Handgrip strength is a simple, quick, non-invasive, inexpensive, rapid, and objective procedure. In addition, it has other advantages as a diagnostic/screening tool for nutritional assessment. However, HGS relies on the motivation of the subjects, and therefore it is imperative that researchers and clinicians are sufficiently trained in HGS assessment. L-carnitine supplementation, levocarnitine is an amino acid derivative which is an essential cofactor of fatty acid metabolism, may improve several situations. However, there is still a big controversy surrounding L-Carnitine supplementation in dialysis patients and limited data is also available on possible benefits of L-Carnitine supplementation in uremic patients. The aim of our study, a longitudinal observational study, is to assess HGS as an independent tool for assessment of the nutritional status in hemodialysis patients. This study can also show the significance of the commitment to high protein diet (1.2- 1.4 g/kg/ d) and receiving L-carnitine (10-20 mg/kg intravenously after each dialysis session) and its effect on the handgrip strength and other studied nutritional tools

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