Assessment of nutritional status of hemodialysis patients by subjective global assessment score: a single centre study from Karachi, Pakistan

Abstract

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...

Prevalence and factors associated with malnutrition among hemodialysis patients in a single hemodialysis center in Vietnam: A cross-sectional study

“…Our study also found that patients undergoing long-term dialysis were at higher risk of developing malnutrition, as studies have reported significant loss of amino acids and protein during dialysis sessions. Similar findings regarding the relation between dialysis vintage and malnutrition in dialysis patients were observed in a Pakistan study [ 21 ] and a Tanzania study. [ 20 ]…”

“…The prevalence of malnutrition in our study was even higher than those reported in Tanzania (61.2%) and Pakistan (64%). [ 20 , 21 ] Although the differences in the reported prevalence among studies conducted in different countries may be attributed to variations in assessment tools and criteria, the proportion of malnutrition appeared to be consistently high among hemodialysis patients. This highlights the urgent need for early identification and management of malnutrition in hemodialysis patients to improve their outcomes.…”

“…Each parameter was scored from 1 (normal) to 5 (severe), of which the sum ranged from 7 to 35 (Table 1). The patients were then classified as well-nourished (score of 7-10), mildly-moderately malnourished (score of [11][12][13][14][15][16][17][18][19][20][21][22], or severely malnourished (score of [23][24][25][26][27][28][29][30][31][32][33][34][35].…”