Arshad Abdul Rehman, Jamal Shanzay, Amanullah Khadija
Nephrology, Combined Military Hospital Peshawar, Peshawar, PAK.
Nephrology, Pak-Emirates Military Hospital, Rawalpindi, PAK.
Cureus. 2020 Mar 26;12(3):e7429. doi: 10.7759/cureus.7429.
Background Malnutrition is directly related to morbidity and mortality in end-stage renal disease. This should be picked up using simple techniques. Methods Adult patients on maintenance haemodialysis were included using a consecutive sampling technique. Compliance was assessed from attendance register (minimum 75% attendance for good compliance). Hypoalbuminemia signified malnutrition. Blood samples for measurement of haemoglobin, serum albumin, calcium and phosphate levels were drawn from the dialyser tubing at the start of the first of the two haemodialysis sessions for each patient. Height and weight were recorded at the end of the first haemodialysis session for each patient. Mini Nutritional Assessment Questionnaire and Council on Nutrition Appetite Questionnaire were administered in direct face-to-face interviews during two consecutive dialysis sessions. Results There were 116 patients aged 53.46± 14.39 years. Majority were males (83.6%) and on twice a week haemodialysis (69.0%). Malnutrition was present in 30 (25.9%) patients. Serum albumin had a significant relationship with both haemoglobin (R = 0.399; < 0.001) and serum phosphate levels (R = 0.253; = 0.006) but not body mass index (R = 0.028; = 0.769). Mean Mini Nutritional Assessment and Council on Nutrition Appetite scores were 19.45± 5.10 and 26.76± 6.28, respectively. Based on Mini Nutritional Assessment scores, 31 (26.7%) patients were malnourished, 59 (50.9%) were at risk of malnutrition, and 26 (22.4%) had normal nutritional status. Council on Nutrition Appetite scores were low in 65 (56.0%) patients, indicating risk of weight loss in next six months. Serum albumin had significant correlation with Mini Nutritional Assessment scores (R = 0.381; < 0.001) and Council on Nutrition Appetite scores (R = 0.290; = 0.002). Slopes of linear regression for Mini Nutritional Assessment and Council on Nutrition Appetite scores were not statistically different (= 0.202). Conclusions Mini Nutritional Assessment and Council on Nutrition Appetite scores had a similar correlation with serum albumin levels. Either of the two could be used for evaluation of malnutrition in end-stage renal disease.
营养不良与终末期肾病的发病率和死亡率直接相关。应采用简单的技术来发现这一问题。方法:采用连续抽样技术纳入接受维持性血液透析的成年患者。根据出勤登记评估依从性(良好依从性要求出勤率至少达到75%)。低白蛋白血症表示营养不良。在每位患者的两次血液透析疗程中的第一次开始时,从透析器管道采集血样,以测定血红蛋白、血清白蛋白、钙和磷水平。在每位患者的第一次血液透析疗程结束时记录身高和体重。在连续两次透析疗程期间,通过直接面对面访谈的方式发放微型营养评定问卷和营养食欲委员会问卷。结果:共有116例患者,年龄为53.46±14.39岁。大多数为男性(83.6%),每周进行两次血液透析(69.0%)。30例(25.9%)患者存在营养不良。血清白蛋白与血红蛋白(R = 0.399;P < 0.001)和血清磷水平(R = 0.253;P = 0.006)均有显著相关性,但与体重指数无关(R = 0.028;P = 0.769)。微型营养评定的平均得分和营养食欲委员会问卷的平均得分分别为19.45±5.10和26.76±6.28。根据微型营养评定得分,31例(26.7%)患者营养不良,59例(50.9%)患者有营养不良风险,26例(22.4%)患者营养状况正常。65例(56.0%)患者的营养食欲委员会问卷得分较低,表明在接下来的六个月中有体重减轻的风险。血清白蛋白与微型营养评定得分(R = 0.381;P < 0.001)和营养食欲委员会问卷得分(R = 0.290;P = 0.002)均有显著相关性。微型营养评定得分和营养食欲委员会问卷得分的线性回归斜率无统计学差异(P = 0.202)。结论:微型营养评定得分和营养食欲委员会问卷得分与血清白蛋白水平的相关性相似。两者中的任何一个都可用于评估终末期肾病患者的营养不良情况。