Nutrition screening tools as predictor of malnutrition for hemodialysis patients in Dr. Sardjito Hospital in Yogyakarta, Indonesia.

The risk of malnutrition in maintenance hemodialysis (MHD) patients must be monitored routinely through nutrition screening so that morbidity and mortality can be decreased. Comparing the validity of the simple nutrition screening tool (SNST) and nutritional risk screening 2002 (NRS 2002) as valid and reliable nutrition screening tools in predicting malnutrition. The data were collected from March to April 2015 in the Hemodialysis Unit of Dr. Sardjito Hospital, Indonesia as an observational study. A cross-sectional design study was used to screen 105 MHD patients using the SNST and NRS 2002, and then, the nutritional status of all individuals was assessed used the following subjective parameters: subjective global assessment (SGA) and dialysis malnutrition score (DMS). The objective parameters were the following: Body mass index (BMI), mid-upper-arm circumference (MUAC), handgrip strength (HGS), and a three-day food record. Chi-squared test, t-test, and receiving operating characteristic curve were used for the statistical analysis. In predicting malnutrition, the validity of the SNST is better than the NRS 2002 in MHD patients against either SGA (Se 94.3% vs. 82.9%; Sp 60% vs. 58.6%; and area under curve (AUC) 0.847 vs. 0.749) or DMS (Se 90.0% vs. 81.6%; Sp 74.0% vs. 62.8%; and AUC 0.833 vs. 0.746), while the NRS 2002 is better than the SNST based on BMI, MUAC, HGS, and energy intake (P <0.001). In predicting malnutrition, SNST is better than NRS 2002 based on the subjective assessments (SGA and DMS), and NRS 2002 is better than SNST based on the objective assessments (BMI, MUAC, and HGS).