Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64%).None of patient had severe malnourishment. Females were 2.6 times more prone for malnourishment (p value=0.009). More than 5- years on hemodialysis also increased the risk of malnourishment by 12.5 times (p value <0.001). Overweight patients had 85 % less chance of being malnourished as compare to patients with normal weight (p value=0.004). Conclusion: Malnutrition is quite common in hemodialysis patients, which necessitates its regular assessment and monitoring. There is a need to assess the reasons of more malnourishment in female as compared to male. Similarly, the longer duration (> 5 years) on hemodialysis also need attention for prevention and cure of malnourishment.  Continuous...

Objective: To determine the frequency of iron deficiency anaemia in non-dialysis chronic kidney disease patients. Method: The observational, cross-sectional study was conducted at the Department of Nephrology, The Kidney Centre Post-Graduate Training Institute, Karachi, from April 27 to October 26, 2018, and comprised adult patients of either gender diagnosed with anaemia and estimated glomerular filtration rate <90ml/min. Patient with transferrin saturation <20% were labelled as having iron deficiency anaemia. Data was analysed using SPSS 21. Results: Of the 366 participants, 185(50.5%) were males and 181(49.5%) were females. The overall mean age was 54.47±14.93 years. The most prevalent comorbid was hypertension 263(71.9%), followed by diabetes mellitus 187(51.1%) and cardiovascular disease 54(14.8%). Besides, 192(52.5%) patients had CKD stage 5 followed by 115(31.4%) and 54(14.8%) with CKD stages 4 and 3, respectively. The mean haemoglobin was 9.17±1.57g/dL. Iron deficiency was found in 285(77.9%) patients. Conclusion: Iron deficiency anaemia was found to be highly prevalent and should be screened routinely and managed appropriately. Key Words: Iron deficiency, Anaemia, Chronic kidney disease.

Background: Decrease in bone mineral density (BMD) increases the risk of osteopenia and osteoporosis. It is common in older women, as the BMD tends to decrease with age, particularly after menopause. While age and hormonal changes are well-established risk factors, other factors have been investigated for possible links to increase the risk of osteoporosis. These factors include dietary patterns and lifestyle. Aim: To explore the association between soft drink consumption and BMD. Method: This cross-sectional study included data from 1000 Qatari women age ≥ 40 year’s participated in the Qatar Biobank Study. BMD levels were measured using the Dual-Energy X-ray Absorptiometry (DXA) scan and the soft drink consumption was assessed using a food frequency questionnaires. Multiple quantile regression models were used to assess the association between bone mineral density and soft drink consumption. Results: While most of the participants did not drink soft drinks (68%), around one third reported consuming soft drinks. A total of 16.4% of participants reported consuming soft drinks < 1 time/ week and 15.6% of participants reported consuming soft drinks ≥ 1 time/ week. There was an inverse association between BMD and soft drink consumption. Compared with non-consumers, ≥ 1 time/week consumption of soft drink had a -0.034 95%CI (-0.056, -0.012) at 0.25 quantile for BMD after adjusting for age, BMI, menopausal status, smoking status, physical activities, milk intake, and fruit and vegetable consumption. Also, BMD was negatively associated with regular soft drinks, but not with diet soft drink and energy drink. Conclusion: High consumption of soft drink is inversely related to BMD among Qatari women. Further longitudinal and clinical studies are required before developing public health intervention to improve bone health by reducing soft drink consumption.