BACKGROUND The relationship between muscle strength and chronic kidney disease (CKD) in children is unknown. This study aims to quantify the association between grip strength (GS) and kidney function and to explore factors associated with grip strength in children and adolescents with CKD. METHODS We included 411 children (699 GS assessments) of the Chronic Kidney Disease in Children (CKiD) study. They were matched by age, sex, and height to a healthy control from the National Health and Nutrition Examination Survey to quantify the relationship between GS and CKD. Linear mixed models were used to identify factors associated with GS among CKD patients. RESULTS Median GS z-score was - 0.72 (IQR - 1.39, 0.11) among CKD patients with CKD stages 2 through 5 having significantly lower GS than CKD stage 1. Compared with healthy controls, CKiD participants had a decreased GS z-score (- 0.53 SD lower, 95% CI - 0.67 to - 0.39) independent of race/ethnicity and body mass index. Factors associated with reduced GS included longer duration of CKD, pre-pubertal status, delayed puberty, neuropsychiatric comorbidities, need of feeding support, need for alkali therapy, and hemoglobin level. Decreased GS was also associated with both a lower frequency and intensity of physical activity. CONCLUSIONS CKD is associated with impaired muscle strength in children independent of growth retardation and BMI. Exposure to CKD for a prolonged time is associated with impaired muscle strength. Potential mediators of the impact of CKD on muscle strength include growth retardation, acidosis, poor nutritional status, and low physical activity. Additional studies are needed to assess the efficacy of interventions targeted at these risk factors.

中文翻译：

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儿童慢性肾脏疾病的握力。

背景技术儿童的肌肉力量与慢性肾脏疾病（CKD）之间的关系尚不清楚。这项研究旨在量化握力（GS）和肾功能之间的关联，并探讨与CKD儿童和青少年的握力有关的因素。方法我们纳入了411例儿童慢性肾脏病（CKiD）研究（699 GS评估）。他们通过年龄，性别和身高与国家健康和营养检查调查中的健康对照相匹配，以量化GS和CKD之间的关系。线性混合模型用于确定CKD患者中与GS相关的因素。结果CKD 2至5期CKD患者的GS z得分中位数为-0.72（IQR-1.39，0.11），其GS明显低于CKD 1期。CKiD参与者的GS z分数降低（降低了-0.53 SD，95％CI-0.67至-0.39），而与种族/民族和体重指数无关。与GS降低相关的因素包括CKD持续时间延长，青春期前状态，青春期延迟，神经精神病合并症，需要喂养支持，需要碱疗法和血红蛋白水平。GS降低还与体力活动的频率降低和强度降低有关。结论CKD与儿童的肌肉力量受损有关，与生长迟缓和BMI无关。长时间暴露于CKD与肌肉力量受损有关。CKD对肌肉力量影响的潜在中介包括生长发育迟缓，酸中毒，营养状况不佳和体育锻炼量低。