Mortality and Nutritional Status in Patients Undergoing Hemodialysis

Bashardoust, Bahman; Gavami, Maryam; Maleki, Nasrollah; Doustkami, Hossein; Habibzadeh, Shahram

doi:10.17795/semj20076

Cited by 7 publications

(6 citation statements)

References 30 publications

(27 reference statements)

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“…This result is consistent with previous studies, where malnutrition and obesity prevalence in maintenance hemodialysis patients were simultaneously assessed 37,38 . These studies have shown an overlap between patients with malnutrition and those with obesity, indicating a problem with nutritional assessment methodologies, further supporting the fact that BMI may not be a reliable indicator for nutritional assessment among maintenance hemodialysis patients [39][40][41][42][43][44][45] , but BMI is relatively easy, inexpensive and less time consuming to measure than modified SGA score 23,46…”

Section: Discussionmentioning

confidence: 99%

Comparison of Body Mass Index with Modified Subjective Global Assessment for Detection of Malnutrition Among Patients Under Maintenance Hemodialysis: A Multi-Center Cross-Sectional Study

Rahman

Haque

Sultana

et al. 2022

JOPSOM

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Background: Patients under maintenance hemodialysis are at increased risk of malnutrition, causing from multitude of factors. Present study aims to assess the prevalence of malnutrition among maintenance hemodialysis patients using both modified subjective global assessment score and body mass index, compare them and assess the sensitivity and specificity of body mass index for detecting malnutrition, along with determining a new cutoff value for BMI that better represent the maintenance hemodialysis patient’s nutritional status. Methods: This was a cross-sectional study conducted in the hemodialysis unit of Bangabandhu Sheikh Mujib Medical University, Sir Salimullah Medical College Mitford Hospital, BIRDEM General Hospital and National Institute of Kidney Diseases & Urology; among 80 adult CKD patients who were on regular (≥2 sessions per week) maintenance hemodialysis for more than 3 months without any acute infection, during the period of July 2016 to June 2017. Nutritional assessment was done for each patient using modified SGA score along with BMI. Sensitivity analysis of WHO recommended cutoff value for BMI was done among the study population using modified SGA score as gold standard test for detection of malnutrition among the respondents. ROC curve was used to estimate the best fitting cutoff value of BMI that showed highest sensitivity, specificity and accuracy for detracting malnutrition among maintenance hemodialysis patients. Results: The study participants were predominantly male (66.3%) and from age group 45 to 59 years (36.3%). Modified SGA score detected 90.0% of the study population as malnourished. WHO recommended 18.5 kg/m2 cutoff value was also used to detect malnutrition among study population and 13.8% were found to be malnourished, with a sensitivity and specificity of 12.5% and 75.0% respectively. Accuracy was found to be 18.8%. Using ROC curve, 23.1 kg/m2 was found to be the best fitting cutoff value of BMI for the study population to detect malnutrition. With a sensitivity of 47.2%, specificity of 37.5% and accuracy of 46.3%. Conclusion: BMI showed low sensitivity for detecting malnutrition among patients under maintenance hemodialysis, compared to modified SGA score and should be avoided as a screening tool, but 23.1 kg/m2 cutoff value for BMI showed potential to be used as an easy to use and quick tool for detecting malnutrition among such patients. Further study with larger sample size could shed more light on this. JOPSOM 2021; 40(1): 14-21

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Section: Discussionmentioning

confidence: 99%

Comparison of Body Mass Index with Modified Subjective Global Assessment for Detection of Malnutrition Among Patients Under Maintenance Hemodialysis: A Multi-Center Cross-Sectional Study

Rahman

Haque

Sultana

et al. 2022

JOPSOM

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“…Similar findings were also reported in different parts of world. [23][24] However, few studies have shown there is no significant correlation of duration of hemodialysis and malnutrition. 13,25…”

Section: Methodsmentioning

confidence: 99%

Nutritional Status of Patients on Maintenance Hemodialysis in a Tertiary Referral Hospital of Nepal

Maskey

Regmi

Katuwal

2017

Med. J. Shree Birendra Hosp.

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“…12 Despite advances in dialysis technology, hemodialysis patients (HDPs) face a higher risk of morbidity and mortality from malnutrition and inflammation complex syndrome (MICS), which adversely affects their defense system, quality of life (QOL), and survival. 11,[21][22][23][24] Nutrition is essential in maintaining hemodialysis patients' excellent health. 5 Bramania et al 23 reported that HDPs are at higher risk of malnutrition because of multiple factors.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with the malnutrition inflammation score (MIS) among hemodialysis patients in Dhaka city: a cross-sectional study in tertiary care hospitals

Bint Harun,

Kawser,

Nabi

et al. 2024

Porto Biomedical Journal

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Background: Chronic kidney disease (CKD) is a progressive disease that leads to end-stage renal disease (ESRD). Malnutrition increases the risk of mortality among patients with ESRD. This study aimed to determine malnutrition prevalence and associated factors among twice-weekly (n = 94/120) and thrice-weekly (n = 26/120) hemodialysis patients/HDP. Method: A cross-sectional study was conducted at two tertiary-level public hospitals in Dhaka city using a consecutive sampling technique from April to June 2021. Nutritional status was assessed by Malnutrition Inflammation Score (MIS). Multivariable ordinal logistic regression was performed to determine which socioeconomic, clinical, anthropometric, biochemical, and dietary factors are associated with MIS. Results: The prevalence of malnutrition was very high among HDP (severe 15.5%, mild/moderate 56.7%) with an average dialysis vintage of 28.7 months. Comorbidities (80.8%) and gastrointestinal symptoms/GIS (68.3%) were ubiquitous, and “dialysis frequencies” were not associated with MIS in bivariate analysis. Multivariable ordinal regression showed that anthropometric factors like mid-upper arm circumference/MUAC (adjusted odds ratio/AOR = 0.978), post-dialysis body mass index/BMI (AOR = 0.957), and biochemical parameters like albumin (AOR = 0.733) and TIBC/total iron binding capacity (AOR = 0.996) negatively (P < .05) associated with MIS. Moreover, having “no GIS” (AOR = 0.672, P < .001) was 33.0% less likely to be associated with MIS. Contrarily, as the month of dialysis increases, MIS increases by 22.0% (AOR = 1.22). Conclusion: Significant associations of clinical, anthropometric, and biochemical characteristics with MIS indicate the importance of routine screening of the nutritional status of patients with CKD to improve health status and prevent protein-energy wasting. The MIS could be a simple, noninvasive tool for testing nutritional status in patients with CKD.

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Mortality and Nutritional Status in Patients Undergoing Hemodialysis

Cited by 7 publications

References 30 publications

Comparison of Body Mass Index with Modified Subjective Global Assessment for Detection of Malnutrition Among Patients Under Maintenance Hemodialysis: A Multi-Center Cross-Sectional Study

Comparison of Body Mass Index with Modified Subjective Global Assessment for Detection of Malnutrition Among Patients Under Maintenance Hemodialysis: A Multi-Center Cross-Sectional Study

Nutritional Status of Patients on Maintenance Hemodialysis in a Tertiary Referral Hospital of Nepal

Factors associated with the malnutrition inflammation score (MIS) among hemodialysis patients in Dhaka city: a cross-sectional study in tertiary care hospitals

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