Fernanda Galvão de Oliveira Santin1, Fernanda Guedes Bigogno1, Juliana Cordeiro Dias Rodrigues1, Lilian Cuppari2, Carla Maria Avesani3. 1. Graduate Program in Food, Nutrition and Health, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil. 2. Division of Nephrology, Federal University of Sao Paulo, Sao Paulo, Brazil. 3. Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: carla.avesani@gmail.com.
Abstract
OBJECTIVE: To assess the performance of subjective global assessment (SGA), malnutrition inflammation score (MIS), and mini nutritional assessment short-form (MNA-SF) in older adults on hemodialysis (HD) by evaluating their concurrent and predictive validity. DESIGN: An observational and prospective study including older adults on HD. SETTING: Six dialysis units. SUBJECTS: We assessed 137 HD patients aged ≥60 years (71.7% male, 70.2 ± 7.2 years). MAIN OUTCOME MEASURES: The nutritional status was assessed by 7-point SGA, MIS and MNA-SF, and by objective methods. Patients were followed up for 14.5 (8; 26.3) months (median and interquartile) to assess survival. RESULTS: Protein energy wasting (PEW) was present in 63% of the patients when assessed by SGA, in 77% by MIS, and in 26% by MNA-SF. Most objective parameters of patients classified with PEW were lower (P < .05) than those from patients classified as well-nourished by SGA, MIS, and MNA-SF. In addition, the hazard of death was higher for patients classified as PEW by SGA (hazard ratio 2.63 [95% confidence interval 1.14-6.00]), MIS (5.13 [1.19-13.7]), and MNA-SF (2.53 [1.34-4.77]) in comparison to well-nourished patients. CONCLUSIONS: The prevalence of PEW varied depending on the tool applied. SGA, MIS, and MNA-SF had good concurrent and predictive validity for the assessment of nutritional status, but SGA and MIS were likely to perform better than MNA-SF.
OBJECTIVE: To assess the performance of subjective global assessment (SGA), malnutrition inflammation score (MIS), and mini nutritional assessment short-form (MNA-SF) in older adults on hemodialysis (HD) by evaluating their concurrent and predictive validity. DESIGN: An observational and prospective study including older adults on HD. SETTING: Six dialysis units. SUBJECTS: We assessed 137 HDpatients aged ≥60 years (71.7% male, 70.2 ± 7.2 years). MAIN OUTCOME MEASURES: The nutritional status was assessed by 7-point SGA, MIS and MNA-SF, and by objective methods. Patients were followed up for 14.5 (8; 26.3) months (median and interquartile) to assess survival. RESULTS: Protein energy wasting (PEW) was present in 63% of the patients when assessed by SGA, in 77% by MIS, and in 26% by MNA-SF. Most objective parameters of patients classified with PEW were lower (P < .05) than those from patients classified as well-nourished by SGA, MIS, and MNA-SF. In addition, the hazard of death was higher for patients classified as PEW by SGA (hazard ratio 2.63 [95% confidence interval 1.14-6.00]), MIS (5.13 [1.19-13.7]), and MNA-SF (2.53 [1.34-4.77]) in comparison to well-nourished patients. CONCLUSIONS: The prevalence of PEW varied depending on the tool applied. SGA, MIS, and MNA-SF had good concurrent and predictive validity for the assessment of nutritional status, but SGA and MIS were likely to perform better than MNA-SF.
Authors: Clara S A Sugizaki; Nayara P Queiroz; Débora M Silva; Ana T V S Freitas; Nara A Costa; Maria R G Peixoto Journal: J Bras Nefrol Date: 2022 Apr-Jun
Authors: Els Holvoet; Karsten Vanden Wyngaert; Amaryllis H Van Craenenbroeck; Wim Van Biesen; Sunny Eloot Journal: PLoS One Date: 2020-03-04 Impact factor: 3.240
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