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.

Selection of an Acceptable Method of Evaluating Nutritional Status in Hemodialysis Patients Compared to Subjective Global Assessment: A Cross-Sectional Study

2020 ◽  
Author(s):  
Atefe Kohansal ◽  
Zahra Sohrabi ◽  
Hanieh Mirzahosseini ◽  
Moein Naghibi ◽  
Morteza Zare ◽  
...  
Keyword(s):  
Nutritional Status ◽  
International Society ◽  
Global Assessment ◽  
Nutritional Assessment ◽  
Pearson Correlation ◽  
Hemodialysis Patients ◽  
Subjective Global Assessment ◽  
Protein Energy Wasting ◽  
Cross Sectional ◽  
Advantages And Disadvantages

Abstract Background: Protein-energy wasting (PEW) is prevalent among hemodialysis (HD) patients and is associated with poor outcomes. There are various methods for evaluating nutritional status in HD patients that each has its own advantages and disadvantages. We aimed at comparing the methods of normalized protein catabolic ratio (nPCR) and malnutrition universal screening tool (MUST) with subjective global assessment (SGA) in HD patients. Method: We examined 88 HD patients using SGA and MUST questionnaires, and also nPCR were calculated using predialysis and post-dialysis BUN, and Kt/v. Also, patients were assessed for PEW based on the Criteria of the International Society of Renal Nutrition and Metabolism. Methods’ specificity, sensitivity, and precision rates were assessed. Correlations between methods were analyzed using Pearson-correlation. Results: Based on the SGA, MUST, and nPCR methods, almost 41, 30, and 60 percent of patients had malnutrition, respectively. According to the criteria by International Society of Renal Nutrition and Metabolism, more than 90 percent of patients had PEW. SGA was positively and significantly associated with MUST (P≤0.001). Sensitivity for SGA, MUST, and nPCR methods were 100,100, 1.8 %, and their specificity were 98, 98, and 4 %, respectively and their precision rates were 99.7, 98.7, and 3%, respectively. Conclusion: From various methods of nutritional assessment (SGA, MUST, and nPCR), compared to SGA as the common method of nutrition assessment in hemodialysis patients, MUST had the nearest specificity, sensitivity, and precision rate compared to SGA and nPCR method had the lowest ones. nPCR seems to be a flawed marker of malnutrition and it should be more investigated whether MUST can be used instead of SGA or not.

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...

Assessment of nutritional status in hemodialysis patients using patient-generated subjective global assessment

2005 ◽  
Vol 15 (2) ◽  
pp. 211-216 ◽  
Author(s):  
Ben Desbrow ◽  
Judith Bauer ◽  
Claudia Blum ◽  
Amutha Kandasamy ◽  
Alison McDonald ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Global Assessment ◽  
Hemodialysis Patients ◽  
Subjective Global Assessment

Characterization of Gut Microbiota Composition in Hemodialysis Patients With Normal Weight Obesity

2020 ◽  
Vol 105 (6) ◽  
pp. 2006-2014 ◽  
Author(s):  
Ting-Yun Lin ◽  
Ping-Hsun Wu ◽  
Yi-Ting Lin ◽  
Szu-Chun Hung
Keyword(s):  
Gut Microbiota ◽  
Hemodialysis Patients ◽  
Normal Weight ◽  
Normal Body Mass Index ◽  
Fat Percentage ◽  
Β Diversity ◽  
Α Diversity ◽  
Increased Risk ◽  
Normal Weight Obesity ◽  
Underlying Mechanisms

Abstract Background Normal weight obesity (NWO), defined by a normal body mass index (BMI) but increased body fat percentage (BF%), is associated with an increased risk of cardiovascular disease and mortality. NWO is characterized by inflammation and muscle wasting in chronic kidney disease (CKD), but the underlying mechanisms remain largely unknown. Gut microbiota has been implicated in the regulation of host metabolism and may play important roles in the development of NWO in CKD. Methods In this case-control study, we examined the gut microbial diversity and taxonomy in 96 hemodialysis patients with normal weight (BMI &lt; 25 kg/m2 and BF% ≤ 25% for men or ≤ 35% for women; n = 32), NWO (BMI &lt; 25 kg/m2 and BF% &gt; 25% for men or &gt; 35% for women; n = 32), and overweight/obesity (BMI ≥ 25 kg/m2; n = 32), matched for age, gender, and diabetes. BF% was measured using bioimpedance spectroscopy device. Gut microbiota was determined by 16S rRNA sequencing. Results We found that α-diversity was significantly different among the 3 adiposity phenotypes, with NWO being the least diverse. α-diversity was positively correlated with BMI, subjective global assessment score, and physical activity, but negatively correlated with interleukin-6 and tumor necrosis factor-α. Patients with or without NWO were distinguished with respect to principal coordinate analysis of β-diversity. Notably, the relative abundance of butyrate-producing bacteria, such as Faecalibacterium prausnitzii and Coprococcus, was markedly reduced in patients with NWO. Conclusion Our findings support associations between gut dysbiosis and a proinflammatory and catabolic state in hemodialysis patients with NWO.

scholarly journals Assessment of Relationship Between Nutritional Status and Handgrip Strength in Hemodialysis Patients

2020 ◽  
Vol 27 (3) ◽  
pp. E202034
Author(s):  
Sevil Karahan Yılmaz ◽  
Neslişah Rakıcıoğlu
Keyword(s):  
Body Composition ◽  
Nutritional Status ◽  
Body Mass ◽  
Global Assessment ◽  
Handgrip Strength ◽  
Hemodialysis Patients ◽  
Albumin Level ◽  
Subjective Global Assessment ◽  
Upper Arm ◽  
Moderate Positive Correlation

In hemodialysis patients, the prevalence of malnutrition is high; a decrease in muscle strength is observed.  The objective of the research was to evaluate the nutritional status of hemodialysis patients and the relationship between the nutritional status and muscle strength. Materials and Methods. Sixty hemodialysis patients (38 males, 22 females) were chosen from among volunteers. Food consumption, biochemical values, anthropometric measurements, body composition, physical activity status, subjective global assessment, and handgrip strength in individuals were examined. Results. According to subjective global assessment, 73.3% of patients were well-nourished, 26.7% of patients were moderately malnourished. In male patients, a moderate positive correlation was determined between handgrip strength and lean body mass (r=0.359, p<0.05), albumin level (r=0.408, p<0.05), energy intake (r=0.437, p<0.05), protein intake (r=0.345, p<0.05). In female patients, a moderate positive correlation was determined between handgrip strength and body weight (r=0.470, p<0.05), body mass index (r=0.472, p<0.05), triceps skinfold thickness (r=0.530, p<0.05), mid-upper arm circumference (r=0.515, p<0.05), mid-upper arm muscle circumference (r=0.557, p<0.05), lean body mass (r=0.470, p<0.05), body fat content (%) (r=0.588, p<0.05), albumin level (r=0.565, p<0.05). Conclusions. Handgrip strength alongside with more than one method of food consumption, biochemical parameters, subjective global assessment, anthropometric measurements, and body composition should be used for assessing the nutritional status in hemodialysis patients.

scholarly journals Nutritional Status of Out-patient Hemodialysis Patients in a Hospital-based Hemodialysis Centre in Nepal

2018 ◽  
Vol 1 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Ruju Khadka ◽  
Nabin Bahadur Basnet ◽  
Rishi Kumar Kafle
Keyword(s):  
Nutritional Status ◽  
Global Assessment ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Anthropometric Measurements ◽  
Assessment Tools ◽  
Subjective Global Assessment ◽  
Biochemical Assessment

Introduction: Malnutrition is common among patients on chronic hemodialysis and is a risk factor. Nutritional assessment ensures early recognition and appropriate intervention. Dietary interview, physical and anthropometric measurements, biochemical assessment, bio-impedance, and structured assessment tools like subjective global assessment are modalities for identifying and monitoring of nutritional assessment of hemodialysis patients. This study was conducted to assess the nutritional status of hemodialysis patients and identify various factors related to malnutrition.Materials and Methods: A cross-sectional study of 72 chronic hemodialysis patients at a hemodialysis unit in Lalitpur was done. Detailed dietary and personal interview, anthropometric measurements, biochemical assessment, and subjective global assessment were used to collect the data to determine the prevalence of malnutrition among the hemodialysis patients as well as identify various factors related.Results: Malnutrition was prevalent among the respondents. The respondents were mostly male with average age of 50.2 1.9 years and majority being on hemodialysis for more than two years. Though severe malnutrition was absent among the hemodialysis patients assessed, mild to moderate malnutrition was seen in 52.78%. Most of these patients were female and were of older age group. Patients who had malnutrition had experienced a significant weight loss in previous six months. Anthropometric profile, dietary habits, and biochemical profile did not correlate with occurrence of malnutrition in hemodialysis patients.Conclusions: Malnutrition is fairly prevalent in chronic hemodialysis patients which can be identified by subjective global assessment. Elderly patients and patients who are losing weight are risk factors for mild to moderate malnutrition.Nepalese Medical Journal, vol.1, No. 1, 2018, Page: 12-16

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