Nutritional Status of Patients on Maintenance Hemodialysis in a Tertiary Referral Hospital of Nepal

Introduction: Malnutrition is a common problem in hemodialysis patient, which is associated with increased mortality and morbidity. There is paucity of data regarding the nutritional status of patient on maintenance hemodialysis in developing countries. This study attempts to access nutritional status of patients on hemodialysis in tertiary referral hospital on western region of Nepal and correlate it with biochemical and laboratory parameters.Methods: A total of fifty patients on hemodialysis were evaluated. Nutritional assessment was made by Subjective Global Assessment (SGA) score, anthropometrics [Body Mass Index (BMI), Triceps Skin Fold Thickness (TSF), Mid Arm Circumference (MAC), Mid Arm Muscle Circumference (MAMC) and biochemical tests.Results: The study assessed 50 patients (34 males and 16 females) with mean age of 54 ± 14 years. Seventy eight percent (39) patients had mild to moderate malnutrition. Anthropometric parameters like BMI, TSF, MAC with normal nutrition were significantly higher than in patients with mild to moderate malnutrition. Malnutrition score (MS) by SGA significantly correlated with duration of dialysis. However, serum albumin was not statistically significant.Conclusion: Malnutrition is very common in patients undergoing hemodialysis with SGA having significant correlation with duration of dialysis. Routine nutritional monitoring among such patients are extremely important for diagnosing malnutrition early on, thus preventing complications and reducing the morbidity and mortality rates in this population.

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Malnutrition–Inflammation Score is a Useful Tool in Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686080602600616 ◽

2006 ◽

Vol 26 (6) ◽

pp. 705-711 ◽

Cited By ~ 31

Author(s):

Bariş Afşar ◽

Siren Sezer ◽

Fatma Nurhan Ozdemir ◽

Huseyin Celik ◽

Rengin Elsurer ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Assessment Tool ◽

Clinical Laboratory ◽

Correlation Coefficients ◽

Severe Malnutrition ◽

Maintenance Hemodialysis ◽

Anthropometric Parameters ◽

Mortality And Morbidity ◽

Moderate Malnutrition ◽

Inflammation Score

Background Malnutrition–Inflammation Score (MIS) is a quantitative assessment tool based on Subjective Global Assessment (SGA) and predicts mortality and morbidity in maintenance hemodialysis patients. However, there are not enough data about the use of MIS in peritoneal dialysis (PD). In this study, relationships between MIS and prospective hospitalization indices, risk of developing peritonitis, anemia indices, and laboratory and anthropometric parameters were analyzed and compared with SGA in PD. Methods 50 PD patients (M/F 26/24, age 45.2 ± 14.9 years, mean PD duration 30.8 ± 23.1 months) were included. The same physician performed the SGA and MIS evaluations. Clinical, laboratory, and anthropometric parameters were measured. Results 18 patients were classified as SGA-A (without malnutrition), 24 as SGA-B (with moderate malnutrition), and 8 as SGA-C (with severe malnutrition). Increment in MIS was concordant with SGA groups A to C ( p < 0.0001). Peritonitis rate, number of hospitalizations, total number of hospitalization days, erythropoietin requirements, C-reactive protein (CRP), and ferritin levels were positively correlated with MIS ( p < 0.0001). Midarm muscle circumference ( p = 0.04), albumin ( p < 0.0001), prealbumin ( p = 0.001), creatinine ( p = 0.04), hemoglobin ( p = 0.003), transferrin ( p < 0.0001), and cholesterol ( p = 0.009) were negatively correlated with MIS. Correlation coefficients of hospitalization indices, peritonitis rate, anemia indices, erythropoietin requirements, albumin, prealbumin, CRP, and anthropometric parameters were higher with MIS than with SGA. In logistic regression analysis, a higher MIS was independently associated with a higher risk of future hospitalization ( p = 0.029, odds ratio 2.14, confidence interval 1.082 – 4.146). Conclusions This study demonstrated that MIS significantly correlated with clinical, nutritional, inflammatory, and anthropometric parameters and anemia indices in PD patients, and that those correlations were stronger than those with SGA.

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