scholarly journals Prealbumin Serum Concentrations as a Useful Tool in the Assessment of Malnutrition in Hospitalized Patients

2006 ◽  
Vol 52 (12) ◽  
pp. 2281-2285 ◽  
Author(s):  
Gianluigi Devoto ◽  
Fabrizio Gallo ◽  
Concetta Marchello ◽  
Omar Racchi ◽  
Roberta Garbarini ◽  
...  
Keyword(s):  
Nutritional Assessment ◽  
Protein Energy Malnutrition ◽  
Reference Method ◽  
Hospitalized Patients ◽  
Severe Malnutrition ◽  
Serum Concentrations ◽  
Nutritional Index ◽  
Protein Energy ◽  
Sensitivity Specificity ◽  
Worse Prognosis

Abstract Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. Methods: We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). Results: According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showed the best concordance with the standard DNA method (concordance index, 76.8%) and a good sensitivity/specificity profile (83.1%/76.7%) compared with SGA and PINI. Conclusions: We conclude that PAB could represent a feasible and reliable tool in the evaluation of malnutrition, especially in settings where it is difficult to obtain a more detailed and comprehensive nutritional assessment such as the DNA.

Nutritional assessment

2018 ◽  
Author(s):  
John Puntis
Keyword(s):  
Nutritional Assessment ◽  
Protein Energy Malnutrition ◽  
Growth Failure ◽  
Developed Countries ◽  
Nutritional Deficiencies ◽  
Negative Effects ◽  
Healthy Life ◽  
Protein Energy ◽  
Nutritional Needs ◽  
Routine Assessment

Routine assessment of nutritional status should be part of normal practice when seeing any patient. The purpose is to document objective nutritional parameters (e.g. anthropometry), identify nutritional deficiencies, and establish nutritional needs. Protein–energy malnutrition has many adverse consequences including growth failure (identified by reference to standard growth charts). Worldwide, malnutrition contributes to a third of deaths in children under 5 years of age, and one in nine people don’t have enough food to lead an active and healthy life. In developed countries, malnutrition complicates both acute and chronic illness with negative effects on outcomes. In clinical practice, a useful approach to nutritional assessment is to consider three elements: ‘what you are’ (i.e. body habitus—underweight for height; short for age; etc.), ‘what you can do’ (functional activity), and ‘what you eat’ (current nutritional intake).

Nutrition in Children with Kidney Disease: Pitfalls of Popular Assessment Methods

2005 ◽  
Vol 25 (3_suppl) ◽  
pp. 143-146 ◽  
Author(s):  
Bethany J. Foster ◽  
Mary B. Leonard
Keyword(s):  
Body Composition ◽  
High Risk ◽  
Kidney Disease ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Fluid Overload ◽  
Protein Energy Malnutrition ◽  
Protein Energy ◽  
Accurate Picture ◽  
Pubertal Delay

Children with chronic kidney disease (CKD) are considered at high risk for protein-energy malnutrition. Clinical practice guidelines generally recommend an evaluation of numerous nutritional parameters to give a complete and accurate picture of nutritional status. This review summarizes the potential limitations of commonly used methods of nutritional assessment in the setting of CKD. Unrecognized fluid overload and inappropriate normalization of body composition measures are the most important factors leading to misinterpretation of the nutritional assessment in CKD. The importance of expressing body composition measures relative to height or height-age in a population in whom short stature and pubertal delay are highly prevalent is emphasized. The limitations of growth as a marker for nutritional status are also addressed. In addition, the prevailing belief that children with CKD are at high risk for malnutrition is challenged.

scholarly journals Penilaian gizi sederhana: alat penilaian praktis untuk menentukan status gizi pasien rawat inap di rumah sakit

2005 ◽  
Vol 1 (3) ◽  
pp. 137
Author(s):  
Ida Mardalena ◽  
Bambang Suprapto ◽  
Widarto Widarto ◽  
Bhisma Murti
Keyword(s):  
Nutritional Status ◽  
Screening Tool ◽  
Nutritional Assessment ◽  
High Sensitivity ◽  
Hospitalized Patients ◽  
Simple Method ◽  
High Incidence ◽  
Time Required ◽  
Sensitivity Specificity ◽  
Efficient Screening

Background: Absence of effective and efficient screening tool for assessment of nutritional status have lead to high incidence of malnutrition among hospitalized patients.Objective: To develope practical screening tool for assessing nutritional status of hospitalized patients.Method: A simple method of nutritional assessment, called The Simple Nutritional Assessment, was compared to albumin serum as the gold standard. This study involved 50 nurses and 50 hospitalized patients in Dr. Moewardi General Hospital, Surakarta.Result: There was significant concordance of nutritional status assessed by the Simple Nutritional Assessment and the level of albumin serum (k=0,92). Sensitivity, specificity, and likelihood ratio of the Simple Nutritional Assessment compared to serum albumin were 92%, 67–75%, and 3.8, respectively. Internal consistence of the Simple Nutritional ssessment is high (Alpha=0.80). Average time required for doing the assessment was only 5 minutes.Conclusion: The Simple Nutritional Assessment can be used for quick screening of nutritional status of hospitalized patients with high sensitivity and reliability.

Mortality Risk Factors in Acute Protein-Energy Malnutrition

1989 ◽  
Vol 19 (2) ◽  
pp. 82-85 ◽  
Author(s):  
S J Gillam
Keyword(s):  
Socioeconomic Factors ◽  
Protein Energy Malnutrition ◽  
Severe Malnutrition ◽  
Admission Criteria ◽  
Nutritional Rehabilitation ◽  
Factors Associated ◽  
Protein Energy ◽  
Suspected Tuberculosis ◽  
Save The Children ◽  
High Risk Children

The records of 45 children admitted to the Save The Children Fund (UK) Clinic, Dhankuta, East Nepal for nutritional rehabilitation, and who subsequently died, were compared with those of 200 survivors admitted during the same period. Children who died were more likely to have attended the clinic previously (P<0.02), and tended to be younger and lighter than controls. A poor outcome was associated with oedema (P< 0.02), hepatomegaly (P<0.01), suspected tuberculosis (P<0.001) and various socioeconomic factors: children who died came from larger families, ‘single parent’ families (P< 0.01), and were more likely to have lost a sibling (P< 0.01). The irrigated landholdings of dying children's families were on average approximately half the size of those of survivors' families. These socioeconomic factors were associated with more severe malnutrition at presentation. The identification of factors associated with a poor prognosis can help to focus admission criteria and to monitor especially high-risk children where services for the acutely malnourished are limited.

scholarly journals TYPICAL DERMATOSIS IN KWASHIORKOR

2017 ◽  
Vol 10 (8) ◽  
pp. 3 ◽  
Author(s):  
Madan Gopal Rajan ◽  
Rukmini M S ◽  
Sulekha Sinha ◽  
Anupama Hegde ◽  
Poornima Manjrekar
Keyword(s):  
Developing Countries ◽  
Nutritional Support ◽  
Protein Energy Malnutrition ◽  
Family Health ◽  
Skin Lesions ◽  
Severe Malnutrition ◽  
National Family Health Survey ◽  
Protein Energy ◽  
National Family ◽  
Dermatologic Manifestations

Protein-energy malnutrition is the most widespread nutritional deficiency disorder in India, commonly occurring in children aged 6 months-2 years,as per the National Family Health Survey, 2007. The dermatologic manifestations are more florid and characteristic in kwashiorkor than in marasmus.Here, we present a case of a 1½ years old male, with extensive skin lesions, owing to severe malnutrition. Malnourishment is one of the foremostconditions seen in the developing countries. It is essential to provide adequate nutritional support to the growing children and to impart proper education to the mothers with regard to weaning and care during the illness of children aged under 5 years.

scholarly journals Diet quality is associated with malnutrition and low calf circumference in Canadian long-term care residents

BMC Nutrition ◽  
2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Natalie Carrier ◽  
Lita Villalon ◽  
Christina Lengyel ◽  
Susan E. Slaughter ◽  
Lisa Duizer ◽  
...  
Keyword(s):  
Diet Quality ◽  
Long Term Care ◽  
Nutritional Assessment ◽  
Short Form ◽  
Protein Energy Malnutrition ◽  
Mini Nutritional Assessment ◽  
Severe Malnutrition ◽  
Calf Circumference ◽  
Term Care

Abstract Background Older adults living in long-term care (LTC) are nutritionally vulnerable. The purpose of this study was to determine diet quality of Canadian LTC residents and its association with malnutrition and low calf circumference. Methods A cross-sectional study was undertaken in 32 LTC homes across four Canadian provinces. Nutrient adequacy ratios (NARs) were calculated for seventeen nutrients; mean adequacy ratio (MAR) was calculated to describe overall diet quality. Malnutrition risk was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF) and diagnosis of protein/energy malnutrition with the Patient-Generated Subjective Global Assessment (PG-SGA). Calf circumference (CC) was also assessed. Linear and logistic regressions for these outcomes with diet quality as the predictor were conducted adjusting for covariates. Results Average MNA-SF score was 10.7 ± 2.5. Residents (43.5%) had mild/moderate to severe malnutrition based on the PG-SGA and 32.6% had a CC of < 31 cm. Mean MAR score was 0.79 ± 0.09 with significant differences between those requiring eating assistance (0.77 ± 0.11) and those that did not require assistance (0.80 ± 0.07) (p < .05). MAR score was significantly associated with malnutrition in fully adjusted models: MNA-SF scores [β = 5.34, 95% Confidence interval (CI) (2.81, 7.85)] and PG-SGA [Odds ratio (OR) = 0.49, 95% CI (0.38, 0.64)]. Those who had better diet quality were more likely to be well nourished or not at risk. Although several individual nutrients were associated with low CC (< 31 cm), there was no association between overall diet quality (MAR) and low CC. Conclusions Diet quality is associated with malnutrition and individual nutrients (NARs) with a low CC. In addition to calories and protein, nutrient dense diets that promote adequate micronutrient intake are required in LTC.

scholarly journals Nutritional evaluation of stage 5 chronic kidney disease patients on dialysis

2012 ◽  
Vol 130 (6) ◽  
pp. 392-397 ◽  
Author(s):  
Cynthia Mauro Piratelli ◽  
Rodolpho Telarolli Junior
Keyword(s):  
Protein Energy Malnutrition ◽  
Chronic Kidney Failure ◽  
Cross Sectional Study ◽  
Severe Malnutrition ◽  
Upper Arm ◽  
Cross Sectional ◽  
Treatment Unit ◽  
Protein Energy ◽  
Nutritional Monitoring ◽  
The Ideal

CONTEXT AND OBJECTIVE: Patients with chronic kidney failure undergoing dialysis have high prevalence of protein-energy malnutrition. There is still no uniform method for assessing these patients' nutritional status. It is recommended that a set of subjective and objective methods should be applied so that an adequate nutritional diagnosis can be reached. The aim of this study was to evaluate the nutritional profile of patients undergoing hemodialysis. DESIGN AND SETTING: Cross-sectional study conducted in the Dialysis Treatment Unit, Araraquara, São Paulo, Brazil, in 2008. METHODS: Anthropometric and biochemical indicators were characterized for 48 patients who also gave responses to the modified Subjective Global Assessment questionnaire (SGAm), and possible correlations between these indicators were investigated. RESULTS: The frequency of moderate or severe malnutrition ranged from 22% to 54%, according to the parameter used. Regarding the patients' conformity with the ideal weight, 29% of them weighed less than 75% of the ideal, and thus were classified as having moderate or severe malnutrition. The most significant correlations were observed between body mass index (BMI) and the idealness of triceps skinfold (TSF), upper arm circumference (UAC) and upper arm muscle circumference (UAMC); and between SGAm and the idealness of UAC and UAMC. CONCLUSION: The frequency of malnutrition showed great variability among the patients, according to the evaluation criterion chosen. Routine nutritional monitoring and validation of methods for assessing body composition among such patients are extremely important for diagnosing malnutrition early on, thus preventing complications and reducing the morbidity and mortality rates in this population.

scholarly journals Serum albumin and transferrin in protein-energy malnutrition: Their use in the assessment of marginal undernutrition and the prognosis of severe undernutrition

1976 ◽  
Vol 36 (2) ◽  
pp. 255-263 ◽  
Author(s):  
P. J. Reeds ◽  
A. A. O. Laditan
Keyword(s):  
Serum Albumin ◽  
Protein Energy Malnutrition ◽  
Severe Malnutrition ◽  
Serum Transferrin ◽  
Malnourished Children ◽  
Protein Energy ◽  
The Mean ◽  
Index Of Severity ◽  
Mean Concentration ◽  
Made In

1. Deficits in weight- and length-for-age, and serum albumin and transferrin concentrations were determined for children who were either marginally undernourished (twenty-five children) or suffering from either marasmus (thirty-two children) or kwashiorkor (twenty-six children) defined according to the Wellcome Classification (Waterlow, 1972). The measurements were also made in eight children with kwashiorkor after the loss of oedema, and in sixteen children who were recovering from either marasmus or kwashiorkor.2. The mean concentration of serum albumin was similar for children from the ‘under-nourished’ group and from the group with marasmus, but was significantly reduced in those with kwashiorkor.3. The concentration of serum transferrin was significantly reduced in both the group of children with marasmus and those with kwashiorkor. The serum transferrin concentration was significantly lower in children with kwashiorkor when compared with the level in those with marasmus.4. Seventeen children (seven with kwashiorkor and ten with marasmus) died. These children were neither lighter nor shorter than the severely malnourished children who survived. The concentration of serum albumin was not lower in the children who died than in those who survived.5. In contrast to the results for serum albumin concentrations, the children who died had significantly lower levels of serum transferrin than those who survived.6. There was a significant linear relationship between serum transferrin concentrations and the deficits in length-for-age (P < 0·05) and weight-for-length (P < 0·001) in the marginally undernourished children. The deficit in weight-for-length was also linearly related to the serum transferrin concentrations (P < 0·001) in children recovering from severe malnutrition.7. It is suggested that the measurement of serum transferrin concentrations provides an index of severity in severely malnourished children, and should prove useful in field assessments of nutritional status.

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