Prediction of malnutrition using modified subjective global assessment-dialysis malnutrition score in patients on hemodialysis

Janardhan, Vasantha; Soundararajan, P.; Rani, N Vanitha; Kannan, G; Palani, Thennarasu; Chacko, Rosney Ann; Reddy, C. Uma Maheswara

doi:10.4103/0250-474x.89755

Cited by 47 publications

(44 citation statements)

References 22 publications

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“…14,15 Both protein and the energy intake is reduced in chronic kidney disease because of the abnormal metabolism in peripheral as well as in hepatosplanchnic tissues. 16 The malnutrition indicators are serum.…”

Section: Discussionmentioning

confidence: 99%

Subjective global assessment of the patients of chronic kidney disease undergoing dialysis

Gupta

Srivastava

Narain³

et al. 2017

Int J Adv Med

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Background: Malnutrition is an important risk factor in patients with chronic kidney disease and in those undergoing maintenance dialysis. Subjective global assessment is a reliable method to evaluate malnutrition in these patients. This study aims to evaluate malnutrition in patients of chronic kidney disease using subjective global assesment score.Methods: A cross sectional study was conducted at SRN Hospital, Allahabad, Uttar Pradesh, India on patients attending Nephrology Unit from July 2014 to May 2015.The nutritional status of 100 patients was evaluated using dietary recall, anthropometry, biochemical parameter and subjective global assessment. There were 67 males and 23 females. Their mean age was 46.8 years. Subjective global assessment was done using 7 variables derived from medical history and physical examination. Each variable was scored from 1-5 depending on the severity. The subjective global assessment score was correlated with the standard methods.Results: Out of 100 patients 29% were mildly malnourished, 64% were moderately malnourished and 7% were severely malnourished. The age, triceps thickness, serum urea and cholesterol were correlated with the malnutrition score (r value 0.2, -0.3, 0.2, 0.4 respectively and p-value 0.3, 0.002, 0.007, 0.001 respectively). It was found that the serum albumin (r value -0.21, p-value 0.42) level did not correlate well with the subjective global assessment.Conclusions: The subjective global assessment can be used reliably to assess the malnutrition in the patients of chronic kidney disease and hence useful in prognostication of disease and is a convenient bedside tool, operable even with paramedics.

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Section: Discussionmentioning

confidence: 99%

Subjective global assessment of the patients of chronic kidney disease undergoing dialysis

Gupta

Srivastava

Narain³

et al. 2017

Int J Adv Med

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“…In this study, we found that MAC maybe a better marker for the nutritional and inflammatory status which was consistent with previous study. Janardhan et al showed that MAC was significantly correlated with dialysis malnutrition score [23]. Furthermore, Stosovic et al demonstrated that MAC was the most predictive anthropometric factor on mortality in hemodialysis patients [24].…”

Section: Discussionmentioning

confidence: 99%

The Insufficiency Intake of Dietary Micronutrients Associated with Malnutrition-Inflammation Score in Hemodialysis Population

et al. 2013

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The relations between dietary micronutrient, nutritional status and inflammation in hemodialysis patients are still unclear. A cross-sectional study was performed in hemodialysis population. 75 hemodialysis patients from South China participated in the dietary and nutritional assessment. Clinical and dietary data were collected. Nutritional status was assessed by Malnutrition-Inflammation Score (MIS) in addition to related anthropometric measurements. And according to the MIS score, the whole hemodialysis patients were divided into normal nutrition group and malnutrition group. The results showed that mid arm circumference (MAC) negatively correlated with MIS (r = −0.425; P = 0.002). The area under the ROC curve (AUC) for MAC was 0.737 (0.614–0.859). Comparing with the normal nutritional group, lower dietary selenium (Se), copper (Cu), iodine (I) and manganese (Mn) intake were observed among patients with malnutrition (P<0.05). While no significant differences of diverse vitamins were found. In conclusion, MAC was effective indicator for assessing nutritional and inflammatory status (P<0.05). The reduction of dietary Se, Cu, I and Mn intake level may be alarming markers for malnutrition and inflammatory status in hemodialysis patients.

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“…Bunun yanında Beden Kitle İndeksi (BKI) beslenme durumunun belirlenmesinde kullanılabilecek basit ve objektif bir ölçümdür. Kreatinin kinetiklerinin de beslenme durumunun saptanmasında kullanılabilecek metotlardan biri olduğu söylenmektedir (12). Bioelektrik empedans (BIA), çift emisyon X-ray absorbsiyometri (DXA), nükleer manyetik rezonans, bilgisayarlı tomografi, total vücut potasyumu ve total vücut nitrojeni gibi gelişmiş diğer yöntemler de malnütrisyonun saptanması için kullanılabilmektedir (2,13).…”

Section: Malnütrisyonun Saptanmasıunclassified

“…Bioelektrik empedans (BIA), çift emisyon X-ray absorbsiyometri (DXA), nükleer manyetik rezonans, bilgisayarlı tomografi, total vücut potasyumu ve total vücut nitrojeni gibi gelişmiş diğer yöntemler de malnütrisyonun saptanması için kullanılabilmektedir (2,13). Beslenme durumunun değerlendirilmesi amacıyla oluşturulan formlardan biri olan Subjektif Global Değerlendirme (SGA) ve Protein Katabolizma Hızı (PCR) da kullanılan diğer yöntemler arasındadır (12,14). Biyokimyasal bulgulardan ise albümin, prealbümin, transferin ve insülin benzeri büyüme faktörü visseral proteinlerin değerlendirilmesinde kullanılabilir (2,11).…”

Section: Malnütrisyonun Saptanmasıunclassified

“…İnflamasyon olan ve olmayan hastaların albümin seviyelerinde belirgin farklılık görülse de beslenme durumu iyi olan ve malnütrisyonlu prediyaliz hastalarında önemli farklılıklar görülmemektedir (16). Bu sebeple serum albümin seviyesinin diyaliz hastalarında beslenme durumunu belirlemek için iyi bir belirleyici olmadığı öne sürülmektedir (12,16). Tüm bu sonuçlara ve beslenme durumunu saptamak için kullanılabilecek farklı alternatif metotlara rağmen kronik böbrek yetmezliği olan hastalarda beslenme durumunun saptanmasında en yaygın olarak serum albümin seviyesi kullanılmaktadır (17).…”

Section: Malnütrisyon Göstergesi Olarak Hipoalbüminemiunclassified

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The Malnutrition-Inflammation-Atherosclerosis (MIA) Syndrom

Küçükkatırcı¹,

Şanlıer²

2016

Turk Neph Dial Transpl

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ÖzSon dönem böbrek yetmezliği (SDBY) olan hastalarda malnütrisyon, inflamasyon ve ateroskleroz gelişimi oldukça fazla görülmekte ve her bir parametre kendi başına mortalite ve morbidite oranını artırmaktadır. İlk olarak 2000 yılında ortaya atılan malnütrisyon-inflamasyon-ateroskleroz (MIA) sendromunun temelini, SDBY hastalarında serum proinflamatuvar sitokin düzeylerindeki artış ve bu hastalarda sıklıkla görülen malnütrisyon ve ateroskleroz arasındaki ilişki oluşturmaktadır. SDBY hastalarında proinflamatuvar sitokin seviyelerinin artmasıyla anoreksiyanın da arttığı ve bu durumun malnütrisyona zemin hazırladığı bilinmektedir. Aynı zamanda sitokin seviyelerindeki artışa bağlı olarak ortaya çıkan kronik inflamasyon hızlanmış ateroskleroza neden olabilmektedir. MIA sendromunun bileşenlerinin görülme oranının artmasıyla hastaların yaşam süreleri ve kaliteleri azalmaktadır. Bu nedenle derlemede; MIA sendromunun bileşenleri, bileşenlerin birbiriyle etkileşimi ve her bir bileşenle etkin mücadele etmek için izlenecek yollar hakkında bilgi vermek amaçlanmıştır.anahtar sözcükler: Böbrek yetmezliği, Malnütrisyon, İnflamasyon, Ateroskleroz, Beslenme durumu abStRact Development of malnutrition, inflammation and atherosclerosis are commonly seen in end-stage renal disease (ESRD) patients and the rates of mortality and morbidity are increased by each parameter. The basis of the malnutrition-inflammation-atherosclerosis (MIA) syndrome that has been proposed in 2000 for the first time is the relationship between increased serum levels of proinflammatory cytokine, malnutrition and atherosclerosis that are commonly seen in ESRD patients. The increase of proinflammatory cytokine levels in ESRD patients increases the anorexia and this is known to predispose to malnutrition. At the same time, it is reported that chronic inflammation due to elevated cytokine levels causes accelerated atherosclerosis. The life expectancy and quality of life of patients decreases with the increasing incidence of the components of the MIA syndrome. In this review, we aimed to explain the components of the MIA syndrome, the interactions of these components and effective treatment of each component.

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Prediction of malnutrition using modified subjective global assessment-dialysis malnutrition score in patients on hemodialysis

Cited by 47 publications

References 22 publications

Subjective global assessment of the patients of chronic kidney disease undergoing dialysis

Subjective global assessment of the patients of chronic kidney disease undergoing dialysis

The Insufficiency Intake of Dietary Micronutrients Associated with Malnutrition-Inflammation Score in Hemodialysis Population

The Malnutrition-Inflammation-Atherosclerosis (MIA) Syndrom

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