A wide prevalence of sarcopenia is observed depending on the method and cutoff limit applied. This may limit extrapolate on to clinical practice. BIA and SKF were the surrogate methods to assess muscle mass with the best concordance with DXA in elderly MHD patients.

Up to now, there is no single method that provides complete and unambiguous assessment of the nutritional status in chronic kidney disease (CKD). Therefore, it has been recommended the use of many nutritional markers. The subjective global assessment (SGA) contains questions regarding the clinical history and physical examination. Subsequently, other versions of the SGA were developed. The malnutrition inflammation score (MIS) was also developed from the original version of the SGA and consists of 70% of the items common to SGA in addition to objective questions. Since many modifications were proposed in the original form of SGA, the use of these questionnaires in CKD patients has increased substantially in clinical practice. Therefore, this paper aims to review the applicability of the SGA and MIS when applied to assess the nutritional status of CKD patients.

A wide prevalence of sarcopenia is observed depending on the method and cutoff limit applied. This may limit extrapolate on to clinical practice. BIA and SKF were the surrogate methods to assess muscle mass with the best concordance with DXA in elderly MHD patients.

The 7p-SGA and MIS translated into Portuguese can be applied for assessing the nutritional status of elderly patients on HD. Studies testing the applicability of these instruments in adult patients on HD and in peritoneal dialysis should yet be performed.

No abstract

The composite indices of nutritional status have been largely applied to assess protein energy wasting (PEW) in hemodialysis (HD) patients, but the applicability in elderly HD patients remains unknown. We aimed to assess whether the prevalence of PEW differs depending on the composite indice applied and, to evaluate the concurrent concordance between the composite indices and objective methods of nutritional status. Sixty-four elderly HD patients (male 72%; 7073, 4 years old) were included. The indices chosen were those validated for HD and/or with high applicability in clinical practice: 7 points subjective global assessment (7p-SGA), malnutrition inflammation score (MIS), the criteria proposed by the International Society in Renal Nutrition and Metabolism (ISRNM) and the mini-nutrition assessment (MNA). For 7p-SGA and MIS, PEW was defined as score r5 and 4 6, respectively. The objective parameters used to evaluate the concurrent concordance were BMI, body fat % (B Fat; skinfold thicknesses), phase angle (P Angle; BIA), handgrip strength (HGS; dynamometer) and serum albumin. The prevalence of PEW and the objective methods which values differed significantly between wellnourished (WN) x PEW patients across the 4 composite indices are described below: 7p-SGA MIS IRSNM MNA PEW (%) 53% 81% 28% 20% WN x PEW WN x PEW WN x PEW WN x PEW BMI NS NS o0.05 NS B fat % o 0.05 2 o 0.05 1,2 o0.05 1,2 o 0.05 2 P Angle NS o 0.05 1 o0.05 1 NS HGS NS NS NS NS Albumin NS NS NS NS NS: not significant; 1 for male; 2 for female A large variation in the prevalence of PEW was observed among the composite indices. No composite indice agreed concurrently with all objectives methods. The IRSNM, followed by the MIS had the greater concordance with the objective methods in elderly HD patients.http://dx.We aimed to validate the translation of the 7 point subjective global assessment (7 p-SGA) and malnutrition inflammation score (MIS) from English to Portuguese to be applied for elderly patients on hemodialysis (HD). For the translation, the back-translation method was used. First, two independent bilinguals renal dietitians (Portuguese native speakers) worked independently to translate the 7 p-SGA and MIS to Portuguese. After that, the final version was back translated to English by a bilingual English teacher (Portuguese native speaker). In order to investigate the conceptual and semantic equivalence of the translated version, a renal dietitian (English native speaker) compared each item of the original English version of the 7 p-SGA and MIS to the back translated English version by rating the similarity between both questionnaires from 1 to 100 (being 100 the highest degree of similarity). The degree of similarity was 96.8 77.8 for 7p-SGA and 99.6 71.4 for MIS, indicating that the Portuguese versions had equivalent meaning to the original English version. We then performed the validation of the Portuguese version by assessing the concurrent concordance of both nutritional composite indices with objective methods (BMI, body fat %, phase angle...

No abstract

The composite indices of nutritional status have been largely applied to assess protein energy wasting (PEW) in hemodialysis (HD) patients, but the applicability in elderly HD patients remains unknown. We aimed to assess whether the prevalence of PEW differs depending on the composite indice applied and, to evaluate the concurrent concordance between the composite indices and objective methods of nutritional status. Sixty-four elderly HD patients (male 72%; 7073, 4 years old) were included. The indices chosen were those validated for HD and/or with high applicability in clinical practice: 7 points subjective global assessment (7p-SGA), malnutrition inflammation score (MIS), the criteria proposed by the International Society in Renal Nutrition and Metabolism (ISRNM) and the mini-nutrition assessment (MNA). For 7p-SGA and MIS, PEW was defined as score r5 and 4 6, respectively. The objective parameters used to evaluate the concurrent concordance were BMI, body fat % (B Fat; skinfold thicknesses), phase angle (P Angle; BIA), handgrip strength (HGS; dynamometer) and serum albumin. The prevalence of PEW and the objective methods which values differed significantly between wellnourished (WN) x PEW patients across the 4 composite indices are described below: 7p-SGA MIS IRSNM MNA PEW (%) 53% 81% 28% 20% WN x PEW WN x PEW WN x PEW WN x PEW BMI NS NS o0.05 NS B fat % o 0.05 2 o 0.05 1,2 o0.05 1,2 o 0.05 2 P Angle NS o 0.05 1 o0.05 1 NS HGS NS NS NS NS Albumin NS NS NS NS NS: not significant; 1 for male; 2 for female A large variation in the prevalence of PEW was observed among the composite indices. No composite indice agreed concurrently with all objectives methods. The IRSNM, followed by the MIS had the greater concordance with the objective methods in elderly HD patients.http://dx.We aimed to validate the translation of the 7 point subjective global assessment (7 p-SGA) and malnutrition inflammation score (MIS) from English to Portuguese to be applied for elderly patients on hemodialysis (HD). For the translation, the back-translation method was used. First, two independent bilinguals renal dietitians (Portuguese native speakers) worked independently to translate the 7 p-SGA and MIS to Portuguese. After that, the final version was back translated to English by a bilingual English teacher (Portuguese native speaker). In order to investigate the conceptual and semantic equivalence of the translated version, a renal dietitian (English native speaker) compared each item of the original English version of the 7 p-SGA and MIS to the back translated English version by rating the similarity between both questionnaires from 1 to 100 (being 100 the highest degree of similarity). The degree of similarity was 96.8 77.8 for 7p-SGA and 99.6 71.4 for MIS, indicating that the Portuguese versions had equivalent meaning to the original English version. We then performed the validation of the Portuguese version by assessing the concurrent concordance of both nutritional composite indices with objective methods (BMI, body fat %, phase angle...