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Kidney Week

Abstract: SA-PO1048

Nutritional Assessment in Dialysis Patients: Are We Missing Something from Subjective Assessment?

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Jasani, Rachana H., Apex Kidney Care, Mumbai, India
  • Kumar, Rajesh B., Apex Kidney Care, Mumbai, India
  • Bichu, Shrirang, Bombay Hospital Near Liberty Theater New Marine Lines, Mumbai, India
  • Kothari, J., Hinduja Hospital,Healthcare & Apex Kidney Foundation, Mumbai, India
  • Billa, Viswanath, Bombay Hospital, Mumbai, India
  • Dedhia, Paras, Apex Kidney Care, Mumbai, India
Background

Malnutrition is very common in dialysis patients and is associated with increased mortality and morbidity. It is not clear whether subjective assessment can accurately identify malnourished dialysis patients. Also, handgrip strength and body composition analysis are not incorporated in nutritional assessment scoring system.

Methods

Nutritional assessment was carried out by subjective and objective parameters on subjects undergoing thrice a week maintenance hemodialysis. Subjective assessment was done using Subjective Global Assessment (SGA) and Dialysis Malnutrition Score (DMS). Objective assessment was done using handgrip strength and body composition analysis. Subjects with albumin less than 3.5 g/dl were considered as malnourished. Handgrip strength analysis was performed by handgrip dynamometer (CAMRY, model EH101) while body composition analysis was performed by Body Composition Monitor (BCM) (Fresenius Medical Care).

Results

Nutritional assessment was conducted on 81 subjects (46 males and 35 females) undergoing thrice a week hemodialysis. The average age was 54.8 ± 12.7 years and average BMI was 24.8 ± 4.3. The average serum albumin was 3.2 ± 0.3 g/dl. Malnutrition was observed in 76.5% subjects by albumin <3.5 g/dl criteria. On subjective assessment, 55 % and 69.3% subjects were found to be malnourished by SGA and DMS scores respectively. Handgrip strength and BCM (objective assessment), categorized 89% subjects as malnourished.

Conclusion

Subjective assessment is not accurate in identifying malnourished dialysis patients. Simple, bedside tools like handgrip strength and body composition monitor may help to better characterize nutritional assessment and early intervention in dialysis patients.