Comparison of Subjective Global Assessment (SGA) and Protein Energy Wasting (PEW) Score to Nutrition Evaluation Conducted by Registered Dietitian Nutritionists (RDNs) in Identifying Risk of PEW in Maintenance Hemodialysis (MHD) Patients

2017 ◽  
Vol 27 (2) ◽  
pp. 144
Keyword(s):  
Global Assessment ◽  
Maintenance Hemodialysis ◽  
Subjective Global Assessment ◽  
Registered Dietitian ◽  
Protein Energy Wasting ◽  
Protein Energy ◽  
Registered Dietitian Nutritionists

Association of subjective global assessment of nutritional status with gut microbiota in hemodialysis patients: a case–control study

2020 ◽  
Author(s):  
Ting-Yun Lin ◽  
Szu-Chun Hung
Keyword(s):  
Nutritional Status ◽  
Gut Microbiota ◽  
Global Assessment ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Subjective Global Assessment ◽  
Protein Energy Wasting ◽  
Β Diversity ◽  
Protein Energy ◽  
Α Diversity

Abstract Background Protein-energy wasting (PEW) is prevalent and associated with adverse outcomes in patients with chronic kidney disease (CKD). However, the pathogenesis of PEW in CKD patients has not been fully identified. The gut microbiota has been implicated in the regulation of host metabolism and energy balance. Therefore, we aimed to explore the association between nutritional status and the composition of the gut microbiota in hemodialysis patients. Methods Gut microbial diversity and taxonomy were examined in 88 hemodialysis patients with PEW (n = 22) and normal nutritional status (n = 66) who were matched 1:3 for age and sex. Nutritional status was assessed by using the 7-point subjective global assessment (SGA) score (1–3 = severe PEW; 4–5 = moderate PEW and 6–7 = normal nutrition). The gut microbiota was assessed by 16S ribosomal RNA gene sequencing. Results Patients with normal nutritional status had a significantly higher body mass index and physical activity and serum albumin levels, but significantly lower levels of inflammatory cytokines than patients with PEW. The most striking finding was that the α-diversity of the gut microbiota was significantly lower in patients with PEW. In a multivariate analysis, the SGA score was independently and positively associated with α-diversity (P = 0.049). Patients with or without PEW were different with respect to the principal coordinate analysis of β-diversity. Notably, the relative abundance of Faecalibacterium prausnitzii, a butyrate-producing bacteria, was markedly reduced in patients with PEW. Conclusion In hemodialysis patients, PEW assessed with the SGA was associated with gut dysbiosis.

Assessment of nutritional status of hemodialysis patients by subjective global assessment score: a single centre study from Karachi, Pakistan

2022 ◽  
Vol 71 (12) ◽  
pp. 2761-2765
Author(s):  
Lubna Ghazi ◽  
Murtaza Dhrolia ◽  
Aamna Hamid ◽  
Ruqaya Qureshi ◽  
Kiran Nasir ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Global Assessment ◽  
Practical Method ◽  
Hemodialysis Patients ◽  
Normal Weight ◽  
Maintenance Hemodialysis ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Subjective Global Assessment ◽  
Cross Sectional

Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64%).None of patient had severe malnourishment. Females were 2.6 times more prone for malnourishment (p value=0.009). More than 5- years on hemodialysis also increased the risk of malnourishment by 12.5 times (p value <0.001). Overweight patients had 85 % less chance of being malnourished as compare to patients with normal weight (p value=0.004). Conclusion: Malnutrition is quite common in hemodialysis patients, which necessitates its regular assessment and monitoring. There is a need to assess the reasons of more malnourishment in female as compared to male. Similarly, the longer duration (> 5 years) on hemodialysis also need attention for prevention and cure of malnourishment.  Continuous...

scholarly journals Clinical Evaluation of Protein Energy Wasting in Maintenance Hemodialysis Patients

2021 ◽  
Author(s):  
ZHANG jing ◽  
TIAN jie ◽  
WANG hongling ◽  
HE zhengzhong
Keyword(s):  
Handgrip Strength ◽  
Abdominal Circumference ◽  
Maintenance Hemodialysis ◽  
Physical Parameters ◽  
Diagnostic Efficiency ◽  
Physical Measurement ◽  
Upper Arm ◽  
Protein Energy Wasting ◽  
Protein Energy ◽  
Arm Circumference

Abstract Background: Protein-energy wasting (PEW) is a common complication of maintenance hemodialysis (MHD) patients. This study aimed to explore the PEW evaluation method in MHD patients. Methods: Clinical data, physical parameters, laboratory values, and a questionnaire survey of MHD patients were collected from PEW and non-PEW patients in our hospital from September to December 2019. Analysis of variance was used to assess the difference between the two groups. ROC analysis was used to compare the diagnostic efficacy of physical measurement and nutrition scores and find the appropriate evaluation criteria for clinical application. Results: 1. There were statistically significant differences in many physical parameters between the two groups (p<0.05). 2. ROC curve analysis showed that the diagnostic efficiency of a single physical measurement or nutritional score was not high, and multiple indexes should be combined. 3. The simplified Pew risk score formula was 27.4 + abdominal circumference + 0.4 * main handgrip strength - 3.2 * body mass index -1.9 * upper arm circumference, which had a sensitivity of 67.7% and specificity of 94.4% at AUC of 0.864 and cutoff of 0.043346. Conclusion: A combination of abdominal circumference, main handgrip strength, BMI, and upper arm circumference could comprehensively evaluate PEW to improve the diagnostic efficiency.

scholarly journals Exploring Metabolic Signature of Protein Energy Wasting in Hemodialysis Patients

Metabolites ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 291 ◽  
Author(s):  
Fatin Athirah Pauzi ◽  
Sharmela Sahathevan ◽  
Ban-Hock Khor ◽  
Sreelakshmi Sankara Narayanan ◽  
Nor Fadhlina Zakaria ◽  
...  
Keyword(s):  
Weight Status ◽  
Partial Least Square ◽  
Least Square ◽  
Controlled Study ◽  
Plasma Metabolites ◽  
Maintenance Hemodialysis ◽  
Protein Energy Wasting ◽  
Metabolic Pattern ◽  
Metabolic Alteration ◽  
Protein Energy

End-stage renal disease patients undergoing maintenance hemodialysis (HD) are vulnerable to the protein energy wasting (PEW) syndrome. Identification and diagnosis of PEW relies on clinical processes of judgment dependent on fulfilling multiple criteria drawn from serum biochemistry, weight status, predictive muscle mass, dietary energy and protein intakes. Therefore, we sought to explore the biomarkers’ signature with plasma metabolites of PEW by using 1H-nuclear magnetic resonance for an untargeted metabolomics approach in the HD population, to understand metabolic alteration of PEW. In this case-controlled study, a total of 53 patients undergoing chronic HD were identified having PEW based on established diagnostic criteria and were age- and sex-matched with non-PEW (n = 53) HD patients. Fasting predialysis plasma samples were analyzed. Partial least square discriminant analysis demonstrated a significant separation between groups for specific metabolic pattern alterations. Further quantitative analysis showed that the level of 3-hydroxybutyrate, acetate, arabinose, maltose, ribose, sucrose and tartrate were significantly increased whilst creatinine was significantly decreased (all p < 0.05) in PEW subjects. Pathway analysis indicated that PEW-related metabolites reflected perturbations in fatty acid mechanism and induction of glyoxylate and dicarboxylate pathway attributed to gluconeogenesis. These results provide preliminary data in understanding metabolic alteration of PEW and corresponding abnormal metabolites that could potentially serve as biomarkers of PEW.

Association of the protein energy wasting (PEW) syndrome with cardiovascular disease (CVD), inflammation and diabetes in patients on maintenance hemodialysis (MHD)

2020 ◽  
Vol 40 ◽  
pp. 533
Author(s):  
M.C. Terroba-Larumbe ◽  
J.M. Palacio-Mures ◽  
M. Gonzalez-Sagrado ◽  
M.C. Crespo-Soto ◽  
D.A. Ticona-Espinoza ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Maintenance Hemodialysis ◽  
Protein Energy Wasting ◽  
Protein Energy
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