Harvinder Gilcharan Singh, Swee Winnie Chee Siew, Karupaiah Tilakavati, Sahathevan Sharmela, Chinna Karuthan, Ahmad Ghazali, Bavanandan Sunita, Goh Bak Leong
Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia.
Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia. Email:
Asia Pac J Clin Nutr. 2016;25(1):26-33. doi: 10.6133/apjcn.2016.25.1.01.
Malnutrition is highly prevalent in Malaysian dialysis patients and there is a need for a valid screening tool for early identification and management. This cross-sectional study aims to examine the sensitivity of the Dialysis Malnutrition Score (DMS) and Malnutrition Inflammation Score (MIS) tools in predicting protein-energy wasting (PEW) among Malaysian dialysis patients.
A total of 155 haemodialysis (HD) and 90 peritoneal dialysis (PD) patients were screened for risk of malnutrition using DMS and MIS and comparisons were made with established guidelines by International Society of Renal Nutrition and Metabolism (ISRNM) for PEW.
MIS cut-off score of >=5 indicated presence of malnutrition in all patients. A total of 59% of HD and 83% of PD patients had PEW by ISRNM criteria. Based on DMS, 73% of HD and 71% of PD patients exhibited moderate malnutrition, whilst using MIS, 88% and 90%, respectively were malnourished. DMS and MIS correlated significantly in HD (r2=0.552, p<0.001) and PD (r2=0.466, p<0.001) patients. DMS and MIS had higher sensitivity values in PD (81% and 82%, respectively) compared to HD (59% and 60%, respectively) patients.
The MIS cut-off scores for malnutrition classification were established (score >=5) for use amongst Malaysian dialysis patients. Both DMS and MIS are valid tools to be used for nutrition screening of dialysis patients especially those undergoing peritoneal dialysis. The DMS may be a more practical and simpler tool to be utilized in the Malaysian dialysis settings as it does not require laboratory markers.
营养不良在马来西亚透析患者中极为普遍，因此需要一种有效的筛查工具用于早期识别和管理。这项横断面研究旨在检验透析营养不良评分（DMS）和营养不良炎症评分（MIS）工具在预测马来西亚透析患者蛋白质 - 能量消耗（PEW）方面的敏感性。
总共155名血液透析（HD）患者和90名腹膜透析（PD）患者使用DMS和MIS进行营养不良风险筛查，并与国际肾脏营养与代谢学会（ISRNM）关于PEW的既定指南进行比较。
MIS临界值≥5表明所有患者存在营养不良。根据ISRNM标准，共有59%的HD患者和83%的PD患者存在PEW。基于DMS，73%的HD患者和71%的PD患者表现为中度营养不良，而使用MIS时，分别有88%和90%的患者营养不良。DMS和MIS在HD患者（r2 = 0.552，p < 0.001）和PD患者（r2 = 0.466，p < 0.001）中显著相关。与HD患者（分别为59%和60%）相比，DMS和MIS在PD患者中的敏感性值更高（分别为81%和82%）。
确定了用于马来西亚透析患者营养不良分类的MIS临界值（评分≥5）。DMS和MIS都是用于透析患者营养筛查的有效工具，尤其是对于接受腹膜透析的患者。由于DMS不需要实验室指标，在马来西亚透析环境中可能是一种更实用、更简单的工具。
