Simon Siu-Man Sum1, Andrea F Marcus2, Debra Blair3, Laura A Olejnik4, Joyce Cao5, J Scott Parrott2, Emily N Peters2, Rosa K Hand6, Laura D Byham-Gray2. 1. School of Health Professions, Rutgers University, Newark, New Jersey; Herbalife Nutrition, Torrance, California. Electronic address: nutritionsimon@gmail.com. 2. School of Health Professions, Rutgers University, Newark, New Jersey. 3. Fresenius Kidney Care, Hampshire County Dialysis, Northampton, Massachusetts. 4. US Renal Care, Inc., Downers Grove, Illinois. 5. Herbalife Nutrition, Torrance, California. 6. School of Medicine, Case Western Reserve University, Cleveland, Ohio.
Abstract
OBJECTIVE: To compare the 7-point subjective global assessment (SGA) and the protein energy wasting (PEW) score with nutrition evaluations conducted by registered dietitian nutritionists in identifying PEW risk in stage 5 chronic kidney disease patients on maintenance hemodialysis. DESIGN AND METHODS: This study is a secondary analysis of a cross-sectional study entitled "Development and Validation of a Predictive energy Equation in Hemodialysis". PEW risk identified by the 7-point SGA and the PEW score was compared against the nutrition evaluations conducted by registered dietitian nutritionists through data examination from the original study (reference standard). SUBJECTS: A total of 133 patients were included for the analysis. MAIN OUTCOME MEASURES: The sensitivity, specificity, positive and negative predictive value (PPV and NPV), positive and negative likelihood ratio (PLR and NLR) of both scoring tools were calculated when compared against the reference standard. RESULTS: The patients were predominately African American (n = 112, 84.2%), non-Hispanic (n = 101, 75.9%), and male (n = 80, 60.2%). Both the 7-point SGA (sensitivity = 78.6%, specificity = 59.1%, PPV = 33.9%, NPV = 91.2%, PLR = 1.9, and NLR = 0.4) and the PEW score (sensitivity = 100%, specificity = 28.6%, PPV = 27.2%, NPV = 100%, PLR = 1.4, and NLR = 0) were more sensitive than specific in identifying PEW risk. The 7-point SGA may miss 21.4% patients having PEW and falsely identify 40.9% of patients who do not have PEW. The PEW score can identify PEW risk in all patients, but 71.4% of patients identified may not have PEW risk. CONCLUSIONS: Both the 7-point SGA and the PEW score could identify PEW risk. The 7-point SGA was more specific, and the PEW score was more sensitive. Both scoring tools were found to be clinically confident in identifying patients who were actually not at PEW risk.
OBJECTIVE: To compare the 7-point subjective global assessment (SGA) and the protein energy wasting (PEW) score with nutrition evaluations conducted by registered dietitian nutritionists in identifying PEW risk in stage 5 chronic kidney diseasepatients on maintenance hemodialysis. DESIGN AND METHODS: This study is a secondary analysis of a cross-sectional study entitled "Development and Validation of a Predictive energy Equation in Hemodialysis". PEW risk identified by the 7-point SGA and the PEW score was compared against the nutrition evaluations conducted by registered dietitian nutritionists through data examination from the original study (reference standard). SUBJECTS: A total of 133 patients were included for the analysis. MAIN OUTCOME MEASURES: The sensitivity, specificity, positive and negative predictive value (PPV and NPV), positive and negative likelihood ratio (PLR and NLR) of both scoring tools were calculated when compared against the reference standard. RESULTS: The patients were predominately African American (n = 112, 84.2%), non-Hispanic (n = 101, 75.9%), and male (n = 80, 60.2%). Both the 7-point SGA (sensitivity = 78.6%, specificity = 59.1%, PPV = 33.9%, NPV = 91.2%, PLR = 1.9, and NLR = 0.4) and the PEW score (sensitivity = 100%, specificity = 28.6%, PPV = 27.2%, NPV = 100%, PLR = 1.4, and NLR = 0) were more sensitive than specific in identifying PEW risk. The 7-point SGA may miss 21.4% patients having PEW and falsely identify 40.9% of patients who do not have PEW. The PEW score can identify PEW risk in all patients, but 71.4% of patients identified may not have PEW risk. CONCLUSIONS: Both the 7-point SGA and the PEW score could identify PEW risk. The 7-point SGA was more specific, and the PEW score was more sensitive. Both scoring tools were found to be clinically confident in identifying patients who were actually not at PEW risk.
Authors: A S Hess; M Shardell; J K Johnson; K A Thom; P Strassle; G Netzer; A D Harris Journal: Eur J Clin Microbiol Infect Dis Date: 2012-03-29 Impact factor: 3.267
Authors: Juan Jesús Carrero; Peter Stenvinkel; Lilian Cuppari; T Alp Ikizler; Kamyar Kalantar-Zadeh; George Kaysen; William E Mitch; S Russ Price; Christoph Wanner; Angela Y M Wang; Pieter ter Wee; Harold A Franch Journal: J Ren Nutr Date: 2013-03 Impact factor: 3.655