Abstract: SA-PO171

The Additional Benefit of Weighted Subjective Global Assessment (SGA) for the Predictability of Mortality in Incident Peritoneal Dialysis Patients

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Yun, Taeyoung, Ewha Womans University , Seoul, Korea (the Republic of)
  • Ryu, Dong-Ryeol, Ewha Womans University , Seoul, Korea (the Republic of)
Background

Although Subjective Global Assessment (SGA) is a widely-used tool for the nutritional investigation, it has limitation to assess nutritional status for the dependence on inspectors’ subjective opinion. Moreover, there is no study for the usefulness of SGA and modified SGA in incident peritoneal dialysis (PD) patients.

Methods

A total of 365 incident PD patients between May 2009 and December 2015 at the 36 centers of the Clinical Research Center for end-stage renal disease in Korea were initially recruited, and we measured SGA and calculated weighted SGA using serum albumin and total iron binding capacity (TIBC) levels based on the normal values. Cox proportional regression analyses were performed and receiver operating curve was also conducted.

Results

During median 3.2 years of follow-up period, 61 patients (16.7%) were dead. Kaplan-Meier curve showed that the cumulative survival rate in ‘Good nutrition (G1)’ was significantly higher compared to that in ‘Mild to severe malnutrition (G2)’ (P < 0.001). G2 was also significantly associated with increase of all-cause mortality even after adjusting for age, gender, several comorbidities and TIBC (HR; 1.78, P = 0.038) compared with G1. Moreover, 1 unit increase of weighted SGA was still significantly correlated with the development of the mortality after adjustment of the same covariates (HR; 1.65, P = 0.013). However, G2 was significantly associated with increase of all-cause mortality in non-DM, DM, and old-aged group (in non-DM; HR; 2.86, P = 0.049, in DM; HR; 2.04, P = 0.021, and in old-aged; HR; 2.96, P = 0.026, respectively) except for young-aged group after adjusting for several covariates, whereas 1 unit increase of weighted SGA was revealed to be significantly related to increase of the mortality in all the subgroup analyses. Furthermore, the AUC of SGA and weighted SGA for all-cause mortality was 0.616 (P = 0.004) and 0.708 (P < 0.001). In addition, the AUCs of weighted SGAs in all the groups were significantly increased compared with those of SGA alone.

Conclusion

The evaluation of nutritional status based on SGA in incident PD patients may be useful for predicting mortality. However, weighted SGA with objective parameters including serum albumin and TIBC can provide an additionally predictable power for all-cause mortality compared with SGA alone.