地域医療と健康教育

抽象的な

Prediction of Malnutrition Using Modified Subjective Global Assessment-Dialysis Malnutrition Score in Patients on Chronic Hemodialysis

Fatin Allawi Mohammed, Hadeel Fadhi Farhood and Moshtak Abdul-AtheemWtwt

Background: Malnutrition is a relatively common problem in patients on hemodialysis (HD) and is associated with increased morbidity and mortality in affected patients. Many factors may contribute to malnutrition in these patients. There is no single measurement that can reliably predict the risk for malnutrition.
Aim of study: Our aim was to determine the risk of malnutrition among hemodialysis (HD) patients in Merjan hospital / dialysis center in Iraq by using modified subjective global assessment, and to examine the relationship between various nutritional and non-nutritional factorsin those patients.
Patients and method: Cross-sectional study was undertaken in Merjan hospital dialysis center in Babylon during the period from 1st of March to 30 of June 2013. Seventy five participants diagnosed with end-stage renal failure (ESRD) were enrolled. These participants who underwent hemodialysis treatment were recruited using a convenience sampling technique. Modified Subjective global assessment (m-SGA), anthropometry, and biochemical measurements were used as evaluative tools.
Results: Nutritional status of the patients was assessed. Mean age of the study population was 51.16 ± 15.03years. Males were older than females. The mean of malnutrition score was 18.61 ± 6.17. This study shows that 32% of our patients were diabetic, while 68% of them were hypertensive; about 68% of those patients had dialysis in frequency of twice per week. Based on MS, (71%) had mild to moderate malnutrition, (23%) patients were having severe malnutrition and remaining (6%) had normal nutrition score. There was no significance of the nutritional status with age, sex, occupation or smoking habit, while there was significance with residence of patients, cause of renal failure and frequency of dialysis that our patients had regarding the laboratory investigation, nutritional status show significance only with serum albumin, and serum phosphate. 99% of our patients were anemic. The anthropometric measurements done were basal metabolic rate BMI, waist / hip ratio W/H ratio, mid arm circumference MAC. The nutritional status was significant with the mid arm circumference MAC, while there was no significance between nutritional status and basal metabolic rate BMI, and waist / hip ratio W/H ratio . 1.4
Conclusions: The frequency of malnutrition is high among patients in our dialysis center, mostly the mild to moderate malnutrition.Most of our patients on maintenance hemodialysis had nutritional problem.