The aim of this study was to evaluate in a group of HDP the prevalence of m and the modifications in time of the nutritional status comparing the sensitivity, specificity and prognostic value of Nutritional Risk Index (NRI) with our Malnutrition Score (MS).
202 patients (p) (M 129, F 73; age 62 15.6 yrs) undergoing hemodialysis from at least 6 months were included in the study. For each p the following factors were taken into consideration: time on dialysis, nephropathy diagnosis and co-morbidities. For nutritional status assessment we considered: SGA; anthropometric measurements; C-reactive protein, albumin, lymphocytes, total cholesterol; BIA. The prevalence and risk of m were assessed by our MS and NRI figure 1. P were followed-up from at least 6 months to 10 years.
The 202 p were assessed with the two screening tools. The prevalence of m according to MS was: score=0 13%; score=1 15%; score=2 16%; score=3 22%; score=4 34%; according to NRI: normal: 12%; light m 27%; moderate m 29%, severe m: 32%. Morbidity and mortality were significantly higher in m patients (p<0.01). Serum albumin used in NRI is a laboratory parameter useful for assessing the nutritional status, however despite its clinical utility, albumin levels can be influenced by non-nutritional factors. Our score includes not only standard indicators of m like anthropometric and biochemical parameters but SGA and BIA parameters so as to be more sensitive and specific and does not use parametric expensive or complex.
Our MS has higher sensitivity and specificity than the NRI and has proved to be an useful and valid tool to identify not only malnourished p but also those at risk of m. Our score by its simplicity can be used in regular assessment of all HDP.
