June 11, 2025

New insights into the links between muscle strength, diet, and phosphate levels in hemodialysis patients

A recent study finds that phosphate levels may not be closely linked to muscle strength in people with advanced kidney disease—though muscle strength itself is tied to important health outcomes, including mortality.

People with advanced kidney disease are at increased risk of muscle wasting, which is associated with a higher risk of mortality. At the same time, many people within this population follow dietary restrictions that limit protein intake to help manage high phosphate levels. In this study, Dror Ben-Noach and colleagues investigated whether people with higher phosphate levels—who may be consuming more protein—also tend to have greater muscle strength.

The researchers recruited 74 people receiving hemodialysis and measured their muscle strength using a handgrip test. They also analyzed participants’ blood phosphate levels, creatinine, and protein metabolism markers.

They found that 33 participants (44.5%) had abnormally low handgrip strength. However, there was no correlation between muscle strength and phosphate levels in the blood. This suggests that simply eating more protein may not be enough to improve muscle strength in dialysis patients.

Notably, people with low handgrip strength were more than nine times more likely to die from any cause compared to those with normal strength. These individuals were also more likely to be older, have diabetes mellitus, and have lower levels of albumin and creatinine, according to the study.