Author(s): AMORIM, C., FERREIRA, I., REIS, J., FINAMOR, R.1, PESTANA, J.1, MOURA, L., Institution: FEDERAL UNIVERSITY OF SÃO PAULO, Country: BRAZIL, Abstract-ID: 1749

INTRODUCTION:
In kidney transplant recipients (KTRs), conventional anthropometry, based on BMI, often masks clinical reality, failing to detect functional decline and metabolic frailty. A rapid and non-invasive screening tool is essential to stratify risk and guide prescription. Our hypothesis was that hand grip strength (HGS) goes beyond a measure of mechanical strength, serving as a systemic indicator of cellular integrity, skeletal muscle reserve, and metabolic status. This study aimed to validate HGS as a primary clinical marker to predict negative structural and metabolic changes in KTRs.
METHODS:
A cross-sectional study evaluated 155 kidney transplant recipients (52.3% men, 47.7% women; mean age 54 ± 12 years). Functional screening was performed using handgrip dynamometry, stratified by sex. Metabolic and structural health was assessed using octapolar bioimpedance (Sanny) to quantify phase angle (PA), skeletal muscle mass (SMM), and body fat percentage, along with waist-to-height ratio (WHR) for central adiposity. Spearman and Mann-Whitney U correlation tests determined the predictive value of handgrip strength on health outcomes.
RESULTS:
Dynapenia was alarmingly prevalent, affecting 91.9% of women and 76.5% of men, despite a homogeneous obesity rate (approximately 76% body fat) between the sexes. Crucially, handgrip strength proved to be a robust predictor of systemic health. Cellular Integrity: Handgrip strength (HGS) showed a strong positive correlation with phase angle in both men (r=0.54, p<0.001) and women (r=0.39, p=0.001), indicating that lower strength effectively predicts cell membrane fragility and poorer nutritional status. Screening for Sarcopenia and Frailty: HGS showed a strong correlation with appendicular skeletal muscle mass (ESM) (Women: r=0.58; Men: r=0.44; p<0.001), validating its use to detect occult muscle depletion. Metabolic Risk: In men, HGS showed an inverse association with visceral adiposity; Men with dynapenia had a significantly worse waist-to-height ratio (WHR) (0.96 vs. 0.93 in men without dynapenia; p=0.036), associating low strength with a high-risk cardiometabolic profile.
CONCLUSION:
Handgrip strength is a powerful and independent biomarker in kidney transplant recipients that transcends neuromuscular function. It successfully predicts negative changes in cellular integrity (phase angle), structural muscle reserve (sarcopenia), and central metabolic risk (visceral fat). Healthcare professionals should prioritize dynamometry as a mandatory vital screening sign to identify metabolic and functional risk early.