Susetyowati Susetyowati, Djarwoto Bambang, Faza Farah
Department of Nutrition and Health, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Internal, Faculty of Medicine, Dr. Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Saudi J Kidney Dis Transpl. 2017 Nov-Dec;28(6):1307-1313. doi: 10.4103/1319-2442.220871.
The risk of malnutrition in maintenance hemodialysis (MHD) patients must be monitored routinely through nutrition screening so that morbidity and mortality can be decreased. Comparing the validity of the simple nutrition screening tool (SNST) and nutritional risk screening 2002 (NRS 2002) as valid and reliable nutrition screening tools in predicting malnutrition. The data were collected from March to April 2015 in the Hemodialysis Unit of Dr. Sardjito Hospital, Indonesia as an observational study. A cross-sectional design study was used to screen 105 MHD patients using the SNST and NRS 2002, and then, the nutritional status of all individuals was assessed used the following subjective parameters: subjective global assessment (SGA) and dialysis malnutrition score (DMS). The objective parameters were the following: Body mass index (BMI), mid-upper-arm circumference (MUAC), handgrip strength (HGS), and a three-day food record. Chi-squared test, t-test, and receiving operating characteristic curve were used for the statistical analysis. In predicting malnutrition, the validity of the SNST is better than the NRS 2002 in MHD patients against either SGA (Se 94.3% vs. 82.9%; Sp 60% vs. 58.6%; and area under curve (AUC) 0.847 vs. 0.749) or DMS (Se 90.0% vs. 81.6%; Sp 74.0% vs. 62.8%; and AUC 0.833 vs. 0.746), while the NRS 2002 is better than the SNST based on BMI, MUAC, HGS, and energy intake (P <0.001). In predicting malnutrition, SNST is better than NRS 2002 based on the subjective assessments (SGA and DMS), and NRS 2002 is better than SNST based on the objective assessments (BMI, MUAC, and HGS).
必须通过营养筛查对维持性血液透析（MHD）患者的营养不良风险进行常规监测，以便降低发病率和死亡率。比较简单营养筛查工具（SNST）和2002年营养风险筛查（NRS 2002）作为有效且可靠的营养筛查工具在预测营养不良方面的有效性。数据于2015年3月至4月在印度尼西亚萨迪托博士医院血液透析科收集，作为一项观察性研究。采用横断面设计研究，使用SNST和NRS 2002对105例MHD患者进行筛查，然后，使用以下主观参数评估所有个体的营养状况：主观全面评定法（SGA）和透析营养不良评分（DMS）。客观参数如下：体重指数（BMI）、上臂中部周长（MUAC）、握力（HGS）和三天饮食记录。采用卡方检验、t检验和受试者工作特征曲线进行统计分析。在预测营养不良方面，在MHD患者中，与SGA（灵敏度94.3%对82.9%；特异度60%对58.6%；曲线下面积（AUC）0.847对0.749）或DMS（灵敏度90.0%对81.6%；特异度74.0%对62.8%；AUC 0.833对0.746）相比，SNST的有效性优于NRS 2002，而基于BMI、MUAC、HGS和能量摄入，NRS 2002优于SNST（P<0.001）。在预测营养不良方面，基于主观评估（SGA和DMS），SNST优于NRS 2002，而基于客观评估（BMI、MUAC和HGS），NRS 2002优于SNST。
