scholarly journals Assessment of Nutritional Status of Nepalese Hemodialysis Patients by Anthropometric Examinations and Modified Quantitative Subjective Global Assessment

2015 ◽  
Vol 8 ◽  
pp. NMI.S27640 ◽  
Author(s):  
Arun Sedhain ◽  
Rajani Hada ◽  
Rajendra Kumar Agrawal ◽  
Gandhi R. Bhattarai ◽  
Anil Baral
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Negative Correlation ◽  
Global Assessment ◽  
Anthropometric Measurements ◽  
Assessment Tools ◽  
Maintenance Hemodialysis ◽  
Subjective Global Assessment ◽  
Skin Fold ◽  
Moderate Malnutrition

Objective To assess the nutritional status of patients on maintenance hemodialysis by using modified quantitative subjective global assessment (MQSGA) and anthropometric measurements. Method We Conducted a cross sectional descriptive analytical study to assess the nutritional status of fifty four patients with chronic kidney disease undergoing maintenance hemodialysis by using MQSGA and different anthropometric and laboratory measurements like body mass index (BMI), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), triceps skin fold (TSF) and biceps skin fold (BSF), serum albumin, C-reactive protein (CRP) and lipid profile in a government tertiary hospital at Kathmandu, Nepal. Results Based on MQSGA criteria, 66.7% of the patients suffered from mild to moderate malnutrition and 33.3% were well nourished. None of the patients were severely malnourished. CRP was positive in 56.3% patients. Serum albumin, MAC and BMI were (mean + SD) 4.0 + 0.3 mg/dl, 22 + 2.6 cm and 19.6 ± 3.2 kg/m2 respectively. MQSGA showed negative correlation with MAC ( r = −0.563; P = < 0.001), BMI ( r = −0.448; P = < 0.001), MAMC ( r = −0.506; P = < .0001), TSF ( r = −0.483; P = < .0002), and BSF ( r = −0.508; P = < 0.0001). Negative correlation of MQSGA was also found with total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol without any statistical significance. Conclusion Mild to moderate malnutrition was found to be present in two thirds of the patients undergoing hemodialysis. Anthropometric measurements like BMI, MAC, MAMC, BSF and TSF were negatively correlated with MQSGA. Anthropometric and laboratory assessment tools could be used for nutritional assessment as they are relatively easier, cheaper and practical markers of nutritional status.

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

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 assessment of nutritional status using the modified quantified subjective global assessment and anthropometric and biochemical parameters in patients undergoing hemodialysis in Macao

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110455
Author(s):  
Hongquan Peng ◽  
Chiwa Aoieong ◽  
Tou Tou ◽  
Tsungyang Tsai ◽  
Jianxun Wu
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Global Assessment ◽  
Severe Malnutrition ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Subjective Global Assessment ◽  
Creatinine Concentration ◽  
Cross Sectional ◽  
Skin Fold Thickness

Objective Malnutrition is widespread among patients undergoing hemodialysis and is linked to high morbidity and mortality rates. We evaluated the nutritional status and malnutrition markers in patients undergoing hemodialysis in Macao. Methods We performed a cross-sectional analysis of 360 patients in a hemodialysis center. The modified quantitative subjective global assessment (MQSGA), anthropometric indices and related biochemical test data were used to evaluate nutritional status. Results The sample's mean age was 63.47 ± 13.95 years. There were 210 well-nourished (58.3%), 139 mild-to-moderately malnourished (38.6%) and 11 severely malnourished (3.1%) patients. Older patients had a higher incidence of severe malnutrition, but there were no significant differences between diabetic and non-diabetic patients. Mid-arm circumference (MAC); mid-arm muscle circumference; body mass index; triceps skin fold thickness; serum albumin, creatinine and urea; and hemoglobin were all valid for assessing nutritional status. MAC and the serum albumin and creatinine concentrations significantly negatively correlated with MQSGA. Conclusions Malnutrition is commonplace in patients undergoing hemodialysis in Macao, but their nutritional status is not affected by diabetes. Serum creatinine, serum albumin and MAC, and especially pre-dialysis creatinine concentration, represent effective, readily available, and easily remembered screening measures of nutritional status for patients undergoing maintenance dialysis.

Comparison of the Performance of Existing Nutritional Screening Tools against Subjective Global Assessment in Cirrhotic Patients

2021 ◽  
Vol 104 (8) ◽  
pp. 1301-1308
Keyword(s):  
Nutritional Status ◽  
Global Assessment ◽  
Screening Tool ◽  
Risk Index ◽  
Assessment Tools ◽  
Screening Tools ◽  
Subjective Global Assessment ◽  
Nutritional Screening ◽  
Nutritional Risk Index ◽  
Cirrhotic Patients

Background: Malnutrition in cirrhosis has a significant negative impact on morbidity and mortality. There is no agreed gold standard of the screening tool. Study comparing the diagnostic properties of nutritional assessment tools in cirrhotic patients is limited. The Subjective Global Assessment (SGA) is one of the global assessment tools. It is used to assess nutritional status in different patient populations. Objective: To evaluate the diagnostic properties of different nutritional screening tools compared with SGA in cirrhotic patients. Materials and Methods: A cross-sectional study was conducted at the HRH Princess Maha Chakri Sirindhorn Medical Center. All cirrhotic patients were enrolled. The nutritional status was evaluated by the SGA, the Royal Free Hospital Subjective Global Assessment (RFH-SGA), the Royal Free Hospital-Nutritional Prioritizing tool (RFH-NPT), the Liver Disease Undernutrition Screening Tool (LDUST), the Malnutrition Universal Screening Tool (MUST), the Prognostic Nutritional Index (PNI-O), the Nutritional Risk Index (NRI), the Spanish Society of Parenteral, the Enteral Nutrition (SENPE), and the Controlling Nutritional Status (CONUT). Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to evaluate RFH-SGA, RFH-NPT, LDUST, MUST, PNI-O, NRI, SENPE, and CONUT compared with SGA. Results: Ninety-four cirrhotic patients were included. The mean age was 60.82 (SD 10.11) years. Patients with cirrhosis Child Turcotte Pugh (CTP) A, B, and C were 62, 21, and 11, respectively. Twenty-five patients (28.7%) were malnourished according to SGA, five with CTP A cirrhosis, twelve with CTP B cirrhosis, and ten with CTP C cirrhosis. The present study also showed that NRI had the highest sensitivity (100%) and LDUST had the highest specificity (94%). Conclusion: NRI is an effective tool with high sensitivity for identifying malnutrition in early stage of cirrhosis. Keywords: Nutritional screening; Cirrhosis; Subjective Global Assessment; SGA; Nutritional Risk Index; NRI

scholarly journals Serum C-reactive protein and nutritional parameters in hemodialysis patients

2019 ◽  
Vol 76 (7) ◽  
pp. 723-727
Author(s):  
Tamara Dragovic ◽  
Mirjana Mijuskovic ◽  
Brankica Terzic ◽  
Danijela Ristic-Medic ◽  
Zoran Hajdukovic ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Total Cholesterol ◽  
Negative Correlation ◽  
Protein Energy Malnutrition ◽  
Maintenance Hemodialysis ◽  
C Reactive Protein ◽  
Dialysis Patients ◽  
Reactive Protein ◽  
Protein Energy

Background/Aim. Inflammation is the most important factor in the genesis of vascular complication in the endstage renal disease. The serum C-reactive protein (CRP) level is a sensitive marker of systemic inflammation as well as a predisposing factor for cardiovascular and all cause mortality in patients on hemodialysis. Albumin is the negative acute phase protein and its synthesis declines during the inflammation. The patients undergoing hemodialysis have a high prevalence of protein-energy malnutrition, due to reduced protein synthesis and increased degradation. The low serum albumin levels in these patients originate from the complex setting of conditions with systemic inflammatory response as a major cause, malnutrition and overhydratation. The aim of this study was to determine the prevalence of elevated CRP levels in the dialysis patients and to analyse its correlation with serum albumin levels and other parameters of nutritional status. Methods. The study included 49 patients on maintenance hemodialysis at the Department of Hemodialysis, Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia. In order to analyse the parameters, the blood samples were taken during the arteriovenous fistula (AVF) puncture and before the second weekly dialyse. The following parameters were determined: serum levels of urea and creatinine before and after the dialysis procedure, CRP, hemoglobin, fasting glycemia, total cholesterol, triglycerides, albumins, iron, glycosylated hemoglobin (HbA1c), fasting insulinemia and C-peptide only before the dialysis. Results. Out of 49 patients on maintenance hemodialysis, 37 (75.5%) were males and 12 (24.5%) females with the average age of 56.04 ? 13.93 years. The average duration of the dialysis treatment was 7.37 ? 5 years. The high serum CRP levels (more than 3 mg/L) was found in 65.3% of patients. Singificantly more diabetic patients were observed in the group with the higher CRP levels (n = 12) compared to the group with the normal CRP levels (n = 3) (p ? 0.05). A significant positive correlation was found between the CRP value and urea values after the dialysis procedure. We found negative correlation between the CRP values and serum albumin, HbA1c, total cholesterol and triglyceride levels, with no statistical significance. Conclusion. Our study observed a high rate of inflammation in the dialysis patients presenting as high frequency of the elevated CRP levels in the examined group. Negative correlation between CRP levels and serum albumin as well as with some other parameters of nutritional status, suggests that chronic inflammation may be the missing link that actually connect protein energy malnutrition with high morbiditiy and mortality rate in these patients.

scholarly journals Circulating fatty acid profiles are associated with protein energy wasting in maintenance hemodialysis patients: a cross-sectional study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ban-Hock Khor ◽  
◽  
Sharmela Sahathevan ◽  
Ayesha Sualeheen ◽  
Mohammad Syafiq Md Ali ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Fatty Acids ◽  
Fatty Acid ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Saturated Fatty Acids ◽  
Maintenance Hemodialysis ◽  
Model Assessment ◽  
Cross Sectional ◽  
Markers Of Inflammation

AbstractThe metabolic impact of circulating fatty acids (FAs) in patients requiring hemodialysis (HD) is unknown. We investigated the associations between plasma triglyceride (TG) FAs and markers of inflammation, insulin resistance, nutritional status and body composition. Plasma TG-FAs were measured using gas chromatography in 341 patients on HD (age = 55.2 ± 14.0 years and 54.3% males). Cross-sectional associations of TG-FAs with 13 markers were examined using multivariate linear regression adjusted for potential confounders. Higher levels of TG saturated fatty acids were associated with greater body mass index (BMI, r = 0.230), waist circumference (r = 0.203), triceps skinfold (r = 0.197), fat tissue index (r = 0.150), serum insulin (r = 0.280), and homeostatic model assessment of insulin resistance (r = 0.276), but lower malnutrition inflammation score (MIS, r =  − 0.160). Greater TG monounsaturated fatty acid levels were associated with lower lean tissue index (r =  − 0.197) and serum albumin (r =  − 0.188), but higher MIS (r = 0.176). Higher levels of TG n-3 polyunsaturated fatty acids (PUFAs) were associated with lower MIS (r =  − 0.168) and interleukin-6 concentrations (r =  − 0.115). Higher levels of TG n-6 PUFAs were associated with lower BMI (r =  − 0.149) but greater serum albumin (r = 0.112). In conclusion, TG monounsaturated fatty acids were associated with poor nutritional status, while TG n-3 PUFAs were associated with good nutritional status. On the other hand, TG saturated fatty acids and TG n-6 PUFAs had both favorable and unfavorable associations with nutritional parameters.

Sign in / Sign up

Export Citation Format

Share Document