Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Aug 12:8:21-7.
doi: 10.4137/NMi.S27640. eCollection 2015.

Assessment of Nutritional Status of Nepalese Hemodialysis Patients by Anthropometric Examinations and Modified Quantitative Subjective Global Assessment

Arun Sedhain  1 , Rajani Hada  1 , Rajendra Kumar Agrawal  1 , Gandhi R Bhattarai  2 , Anil Baral  1
Affiliations

Assessment of Nutritional Status of Nepalese Hemodialysis Patients by Anthropometric Examinations and Modified Quantitative Subjective Global Assessment

Arun Sedhain et al. Nutr Metab Insights. .

Abstract

Objective: To assess the nutritional status of patients on maintenance hemodialysis by using modified quantitative subjective global assessment (MQSGA) and anthropometric measurements.

Method: We Conducted a cross sectional descriptive analytical study to assess the nutritional status of fifty four patients with chronic kidney disease undergoing maintenance hemodialysis by using MQSGA and different anthropometric and laboratory measurements like body mass index (BMI), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), triceps skin fold (TSF) and biceps skin fold (BSF), serum albumin, C-reactive protein (CRP) and lipid profile in a government tertiary hospital at Kathmandu, Nepal.

Results: Based on MQSGA criteria, 66.7% of the patients suffered from mild to moderate malnutrition and 33.3% were well nourished. None of the patients were severely malnourished. CRP was positive in 56.3% patients. Serum albumin, MAC and BMI were (mean + SD) 4.0 + 0.3 mg/dl, 22 + 2.6 cm and 19.6 ± 3.2 kg/m(2) respectively. MQSGA showed negative correlation with MAC (r = -0.563; P = <0.001), BMI (r = -0.448; P = <0.001), MAMC (r = -0.506; P = <.0001), TSF (r = -0.483; P = <.0002), and BSF (r = -0.508; P = <0.0001). Negative correlation of MQSGA was also found with total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol without any statistical significance.

Conclusion: Mild to moderate malnutrition was found to be present in two thirds of the patients undergoing hemodialysis. Anthropometric measurements like BMI, MAC, MAMC, BSF and TSF were negatively correlated with MQSGA. Anthropometric and laboratory assessment tools could be used for nutritional assessment as they are relatively easier, cheaper and practical markers of nutritional status.

Keywords: CKD; MQSGA; anthropometric measuremen; hemodialysis; nutritional status.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Regression lines for MQSGA scores with respect to anthropometric measures.
Figure 2
Figure 2
Comparison of area under ROC curve for all five anthropometric measures.
See this image and copyright information in PMC

References

    1. National Kidney Foundation (NKF)/kidney disease outcome quality initiative (K/DOQI) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis. 2002;39(suppl 1):S1–S266. - PubMed
    1. Must A, Dallal GE, Dietz WH. Reference data for obesity: 85th and 95th percentile for body mass index (wt/ht2) and triceps skin fold thickness. Am J Clin Nutr. 1991;53:839–846. - PubMed
    1. Indian Society of Nephrology. Guidelines for the management of nutrition. Indian J Nephrol. 2005;15(Supl 1):S42–S46.
    1. Todigo G, Aparicio M, Attman P-O, et al. Expert working group report on nutrition in adult patients with renal insufficiency (part 1 of 2) Clin Nutr. 2000;19(3):197–207. - PubMed
    1. Kopple JD. Nutritional status as a predictor of morbidity and mortality in maintenance dialysis patients. ASAIO J. 1997;43(3):246–250. - PubMed