Renal Transplantation and Nephrology Department, Hospital Clinic de Barcelona, 08036 Barcelona, Spain.
Nephrology Department, Hospital del Mar-Parc de Salut Mar, 08003 Barcelona, Spain.
Nutrients. 2022 Aug 17;14(16):3375. doi: 10.3390/nu14163375.
This cross-sectional study aims to explore the prevalence of protein-energy wasting (PEW) in dialysis patients in Catalonia, Spain, using a new and practical online tool which enables rapid calculation and comparison with other nutritional scores.
A web tool (Nutrendial) was created to introduce different variables and automatically calculate PEW, Malnutrition inflammation Score (MIS) and Subjective Global Assessment (SGA) in 1389 patients (88% in haemodialysis (HD)), 12% in peritoneal dialysis (PD) from different regions of Catalonia.
A prevalence of 23.3% (26% HD, 10.2% PD) of PEW was found, with a mean MIS score of 6 and SGA score of C in 7% of the patients. ROC analysis showed MIS as the best nutritional score to diagnose PEW (AUC 0.85). Albumin delivered lower diagnostic precision (AUC 0.77) and sensitivity (66%). A cut off point of 7 (86% sensitivity and 75% specificity) for MIS and 3.7 mg/dL for albumin were found to predict the appearance of PEW in this population. SGA B or C showed an 87% sensitivity and 55% specificity to diagnose PEW. Very low nutritional intervention (14%) was recorded with this tool in patients with PEW.
This new online tool facilitated the calculation of PEW, enabling different professionals-including nephrologists, dieticians and nurses-to efficiently obtain insights into the nutritional status of the Catalonian dialysis population and implement the required nutritional interventions. MIS is the score with more sensitivity to diagnose PEW.
本横断面研究旨在使用一种新的实用在线工具探索西班牙加泰罗尼亚透析患者中蛋白质-能量消耗（PEW）的流行情况，该工具可快速计算并与其他营养评分进行比较。
创建了一个网络工具（Nutrendial），可引入不同变量并自动计算 1389 名患者（88%在血液透析（HD）中，12%在腹膜透析（PD）中）的 PEW、营养不良炎症评分（MIS）和主观全面评估（SGA），这些患者来自加泰罗尼亚不同地区。
发现 PEW 的患病率为 23.3%（HD 为 26%，PD 为 10.2%），患者中有 7%的 MIS 评分平均为 6，SGA 评分为 C。ROC 分析显示 MIS 是诊断 PEW 的最佳营养评分（AUC 0.85）。白蛋白的诊断精度（AUC 0.77）和敏感性（66%）较低。发现 MIS 的截断值为 7（敏感性 86%，特异性 75%）和白蛋白 3.7mg/dL 可预测该人群中 PEW 的出现。SGA B 或 C 对诊断 PEW 的敏感性为 87%，特异性为 55%。使用该工具发现患有 PEW 的患者的营养干预非常低（14%）。
这种新的在线工具便于计算 PEW，使包括肾病学家、营养师和护士在内的不同专业人员能够高效地了解加泰罗尼亚透析人群的营养状况并实施所需的营养干预措施。MIS 是诊断 PEW 更敏感的评分。
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