Subjective global assessment of the patients of chronic kidney disease undergoing dialysis

Abstract

Background: Malnutrition is an important risk factor in patients with chronic kidney disease and in those undergoing maintenance dialysis. Subjective global assessment is a reliable method to evaluate malnutrition in these patients. This study aims to evaluate malnutrition in patients of chronic kidney disease using subjective global assesment score.Methods: A cross sectional study was conducted at SRN Hospital, Allahabad, Uttar Pradesh, India on patients attending Nephrology Unit from July 2014 to May 2015.The nutritional status of 100 patients was evaluated using dietary recall, anthropometry, biochemical parameter and subjective global assessment. There were 67 males and 23 females. Their mean age was 46.8 years. Subjective global assessment was done using 7 variables derived from medical history and physical examination. Each variable was scored from 1-5 depending on the severity. The subjective global assessment score was correlated with the standard methods.Results: Out of 100 patients 29% were mildly malnourished, 64% were moderately malnourished and 7% were severely malnourished. The age, triceps thickness, serum urea and cholesterol were correlated with the malnutrition score (r value 0.2, -0.3, 0.2, 0.4 respectively and p-value 0.3, 0.002, 0.007, 0.001 respectively). It was found that the serum albumin (r value -0.21, p-value 0.42) level did not correlate well with the subjective global assessment.Conclusions: The subjective global assessment can be used reliably to assess the malnutrition in the patients of chronic kidney disease and hence useful in prognostication of disease and is a convenient bedside tool, operable even with paramedics.

The Impact of Blood Flow Rate and Duration of Dialysis Session on Nutritional Status in Hemodialysis Patients

“…The SGA is a tool which can rapidly assess the malnutrition score with a minimal technical requirement and had a high degree of interobserver agreement (Detsky et al, 1987). SGA was found in several studies to be a reliable tool for evaluating nutritional status (Steiber et al, 2007;Dai et al, 2017;Gupta, Srivastava, Narain, & Saraswat, 2017) and associated with clinical characteristics, anthropometric and nutritional biomarkers (Steiber et al, 2007;Dai et al, 2017;De Mutsert et al, 2009). The NKF/DOQI,2000 recommended SGA as a nutrition assessment for the MHD population.…”

Comparison of dietary intake patterns in hemodialysis patients by nutritional status: A cross-sectional analysis

“…Among them, the SGA is a relatively inexpensive, easy, and rapidly conducted tool used by nurses, dietitians, and physicians to assess PEW in chronic HD patients [9]. It is also used to examine the nutritional status of HD patients [10], and several studies have evaluated the relationship between SGA scores and mortality in HD patients [11]. Therefore, we divided HD patients into two groups (well-nourished vs. poorly nourished) based on the SGA and compared their dietary intake levels and food intake patterns.…”

Energy, protein, and potassium intake with nutritional status among chronic renal failure patients undergoing hemodialysis in hospital Dr. M.Yunus, Bengkulu, Indonesia

“…Patients with chronic kidney disease are usually low food intake due to decreased appetite, the onset of nausea, and accompanied by vomiting so that it will affect weight loss, which can cause malnutrition (3) . Moreover, subjective global assessments can be used reliably to assess malnutrition in chronic kidney disease patients and are therefore useful in disease prognostication (4) . Subjective Global Assessment (SGA) for dialysis patient, namely Dialysis Malnutrition Score (DMS) is a tool that uses five components of medical history (changes in body weight, dietary intake, gastrointestinal symptoms, functional ability, comorbidity and their relationship to nutritional needs) and two components of physical examination (simptoms of fat and muscle, replacement nutrients in fluids).…”