Normative Values and Clinical Correlations of Handgrip Strength in Chronic Kidney Disease Patients Undergoing Hemodialysis: A Multicenter Colombian Study

Background: Handgrip strength (HGS) is a simple, low-cost indicator of muscle function and predictor of morbidity and mortality in patients with chronic kidney disease (CKD). Objective: To establish sex- and age-specific normative values for HGS in Colombian patients undergoing hemodialysis and to examine its association with clinical and biochemical factors. Methods: A multicenter, cross-sectional study was conducted between August and September 2023 in five cities across Colombia. A total of 436 hemodialysis patients aged 15 to over 80 years were assessed. HGS was measured post-dialysis using a CAMRY EH101 digital dynamometer in both flexion and extension of each arm. The Box–Cox Power Exponential (BCPE) model within the GAMLSS framework was used to generate percentile curves by sex. Comparisons were performed by sex, diabetes status, and occupation. Spearman’s correlation was used to explore associations between HGS and biochemical variables. Results: Males exhibited significantly higher HGS than females (mean difference: 8.09 kg; p < 0.001). Lower HGS was observed among individuals with diabetes and those unemployed. HGS showed a moderate inverse correlation with alkaline phosphatase (r = −0.29, p = 0.0014) and a weak inverse correlation with KT/V (r = −0.22, p = 0.02). No other biochemical markers showed significant associations. Reference percentiles (P3 to P97) were constructed for both sexes. Conclusions: These normative values for HGS represent the first reference standards for Colombian patients on hemodialysis. HGS assessment may support early identification of functional impairment and inform clinical decisions related to rehabilitation and nutritional support.