Cross-cultural adaptation to Portuguese of tools for assessing the nutritional status of patients on dialysis

Fetter, Renata; Bigogno, Fernanda Guedes; Oliveira, Fernanda Galvão Pasculli de; Avesani, Carla María

doi:10.5935/0101-2800.20140028

Cited by 14 publications

(6 citation statements)

References 29 publications

(33 reference statements)

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“…At baseline, all participants had the nutritional status assessed by the 7-point-subjective global assessment (7p-SGA) translated to Portuguese (12), by anthropometric measurements [body weight, height, midarm circumference, triceps skinfold (SKF) thickness, and hip and calf circumference], bioelectrical impedance (BIA), and handgrip strength (HGS) after 30-60 min the dialysis session in a midweek dialysis day to minimize the influence of fluids overload on body composition (13). SKFs were measured using an SKF caliper (Lange, Cambridge Scientific Industries, Cambridge, MD, USA), following the Lohman's Protocol (14).…”

Section: Methodsmentioning

confidence: 99%

“…The 7p-SGA was applied by experienced renal dietitians. The nutritional status of a patient was classified as wellnourished when the 7p-SGA score was equal to 7 and 6 and, as malnourished when the 7p-SGA score ≤5 (12). A previous study, conducted by our research group and which included patients on HD, showed that this equation had good agreement with the ASM assessed by dual-energy X-ray absorptiometry (DXA) with an intraclass coefficient correlation (ICC) of 0.92 (95% CI: 0.86-0.95) (9).…”

Section: Methodsmentioning

confidence: 99%

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Malnutrition and Sarcopenia Combined Increases the Risk for Mortality in Older Adults on Hemodialysis

et al. 2021

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Aim: Sarcopenia and malnutrition are highly prevalent in older adults undergoing hemodialysis (HD) and are associated with negative outcomes. This study aimed to evaluate the role of sarcopenia and malnutrition combined on the nutritional markers, quality of life, and survival in a cohort of older adults on chronic HD.Methods: This was an observational, longitudinal, and multicenter study including 170 patients on HD aged >60 years. Nutritional status was assessed by 7-point-subjective global assessment (7p-SGA), body composition (anthropometry and bioelectrical impedance), and appendicular skeletal muscle mass (Baumgartner's prediction equation). Quality of life was assessed by KDQoL-SF. The cutoffs for low muscle mass and low muscle strength established by the 2019 European Working group on sarcopenia for Older People (EWGSOP) were used for the diagnosis of sarcopenia. Individuals with a 7p-SGA score ≤5 were considered malnourished, individuals with low strength or low muscle mass were pre-sarcopenic, and those with low muscle mass and low muscle strength combined as sarcopenic. The sample was divided into four groups: sarcopenia and malnutrition; sarcopenia and no-malnutrition; no-sarcopenia with malnutrition; and no-sarcopenia and no-malnutrition. Follow-up for survival lasted 23.5 (12.2; 34.4) months.Results: Pre-sarcopenia, sarcopenia, and malnutrition were present in 35.3, 14.1, and 58.8% of the patients, respectively. The frequency of malnutrition in the group of patients with sarcopenia was not significantly higher than in the patients without sarcopenia (66.7 vs. 51.2%; p = 0.12). When comparing groups according to the occurrence of sarcopenia and malnutrition, the sarcopenia and malnutrition group were older and presented significantly lower BMI, calf circumference, body fat, phase angle, body cell mass, and mid-arm muscle circumference. In the survival analysis, the group with sarcopenia and malnutrition showed a higher hazard ratio 2.99 (95% CI: 1.23: 7.25) for mortality when compared to a group with no-sarcopenia and no-malnutrition.Conclusion: Older adults on HD with sarcopenia and malnutrition combined showed worse nutritional parameters, quality of life, and higher mortality risk. In addition, malnutrition can be present even in patients without sarcopenia. These findings highlight the importance of complete nutritional assessment in patients on dialysis.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Malnutrition and Sarcopenia Combined Increases the Risk for Mortality in Older Adults on Hemodialysis

et al. 2021

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“…The group of patients enrolled in the sensory analysis (n = 60) had their nutritional status assessed by body weight and height, SGA-7p and serum albumin. The SGA-7p, translated and validated to Portuguese, was used [ 17 ], and patients were classified as well-nourished (score 7–6), mild to moderate malnutrition (score 5–3) and severe malnutrition (score 2–1). The same trained dietitian performed both the anthropometric measurements and the SGA-7p.…”

Section: Methodsmentioning

confidence: 99%

Development of muffins as dialysis snacks for patients undergoing hemodialysis: results of chemical composition and sensory analysis

et al. 2020

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Objective This study aimed to develop two non-industrial food products as financially accessible options to prevent and treat malnutrition in hemodialysis (HD) patients. These food products were developed and intended for use as dialysis snacks. Methods This is a cross-sectional and multi-step study. First, 183 adult HD patients (55 ± 14 years; 50.8% males), replied to a questionnaire with their food preferences regarding taste (salty, sweet, bitter, sour) and consistency (liquid, solid, pasty) for a dialysis snack. Most patients preferred a food product with a solid consistency (90%) and a salty flavor (81.4%). Second, three muffin formulations of fine herbs were developed; one enriched with whey protein concentrate (WPC), a second with textured soy protein (TSP) and a third standard formulation without protein for comparison with the protein-enriched muffins, for which the chemical and nutritional compositions were analyzed. In the third step, 60 patients on HD (61 ± 15 years; 53% males) were enrolled in a sensory analysis by applying a 9-point structured hedonic scale, ranging from "extremely liked" (score 9) to "extremely disliked" (score 1). Results When compared with the standard formulation, the formulations enriched with WPC and TSP protein had a significantly higher amount of protein/serving (Standard: 5.9 ± 0.3 g vs WPC: 14.5 ± 0.9 g and TSP 10.8 ± 0.7 g; P < 0.05) but a lower amount of carbohydrate (Standard: 13.1 ± 2.2 g vs WPC: 5.6 ± 0.8 g and TSP 6.0 ± 1.2 g vs; P < 0.05). The mineral content/serving of the protein-enriched muffins was low in phosphorus (50 mg) and sodium (180 mg). The potassium content/ serving was moderate for the WPC muffin (225.2 mg) and low for the TSP muffin (107.9 mg). The acceptability index (AI) for the enriched protein muffins was higher than 70% and similar to the standard formulation. Conclusion The muffins with fine herbs and enriched with protein were well-accepted by all patients and appropriate to serve as dialysis snacks for HD patients.

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“…Each component has a score from 1 to 7. The 7p-SGA scale [ 16 ], validated to Portuguese [ 17 ] classifies patients as well-nourished (score 7 to 6), mild to moderate protein-energy wasting (score 5 to 3) and severe protein-energy wasting (score 2 to 1) [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Design and methodology of the Aging Nephropathy Study (AGNES): a prospective cohort study of elderly patients with chronic kidney disease

et al. 2020

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Background Renal replacement therapy (RRT) is usually indicated for patients with chronic kidney disease (CKD) with glomerular filtration rate below 10 ml/ml/min/1.73m2. However, the need for RRT and timing of dialysis initiation are debatable for patients aged 70 years or older. We here describe the study design and methodology of the Aging Nephropathy Study (AGNES) protocol that aims at evaluating to what extent geriatric-related conditions such as frailty, cognitive dysfunction, and presence of comorbidities have an impact on survival and RRT initiation in this group of patients. In this manuscript we provide detailed information about the AGNES study design and methodology. Methods AGNES is a prospective observational cohort that aim to investigate clinical, biochemical and demographic factors associated with RRT initiation and mortality of patients with CKD stage 4 or 5 who are aged 70 years and older. We plan to include 200 patients over 5 years. Clinically stable outpatients on conservative management for at least 6 months will be recruited from the Nephrogeriatric Clinic at the Hospital das Clinicas da Universidade de Sao Paulo, Brazil. Eligible patients are submitted to a full clinical examination, geriatric assessment, and blood test at baseline. Following the baseline visit the patients are being monitored during an observational follow up period of at least 12 months during which patients will be contacted in the clinic at their regular follow up or by phone until either RRT initiation or death occurs. This cohort includes evaluation of cognition by the education-adjusted 10-point Cognitive Screener (10-CS), frailty by Fried index score, a complete nutritional assessment (by body composition assessment, global subjective assessment and dietary intake), comorbidities by Charlson comorbidity index and biochemical markers including FGF-23 and Klotho. Discussion The AGNES cohort, a real-world study of current clinical practice in elderly patients with advanced CKD prior to dialysis initiation, will shed light into progression of CKD and its complications, indications of RRT and factors determining survival. This investigation will elucidate to what extent geriatric conditions, nutritional status and clinical factors are associated with survival, quality of life and RRT initiation in elderly CKD patients not yet on dialysis. Trial registration Registered on ClinicalTrials.gov on 18 October 2019 (NCT04132492).

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Cross-cultural adaptation to Portuguese of tools for assessing the nutritional status of patients on dialysis

Abstract: 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.

Cited by 14 publications

References 29 publications

Malnutrition and Sarcopenia Combined Increases the Risk for Mortality in Older Adults on Hemodialysis

Malnutrition and Sarcopenia Combined Increases the Risk for Mortality in Older Adults on Hemodialysis

Development of muffins as dialysis snacks for patients undergoing hemodialysis: results of chemical composition and sensory analysis

Design and methodology of the Aging Nephropathy Study (AGNES): a prospective cohort study of elderly patients with chronic kidney disease

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