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Comparative Study
. 2022 Aug 17;14(16):3375.
doi: 10.3390/nu14163375.

Prevalence of Protein-Energy Wasting in Dialysis Patients Using a Practical Online Tool to Compare with Other Nutritional Scores: Results of the Nutrendial Study

Marta Arias-Guillén  1 , Silvia Collado  2 , Elisabeth Coll  3 , Jordi Carreras  4 , Loreley Betancourt  5 , Bárbara Romano  6 , Marisol Fernández  2 , Verónica Duarte  7 , Julia Garro  8 , Jordi Soler  9 , Juan Carlos González  10 , Jordi Calabia  11
Affiliations
Comparative Study

Prevalence of Protein-Energy Wasting in Dialysis Patients Using a Practical Online Tool to Compare with Other Nutritional Scores: Results of the Nutrendial Study

Marta Arias-Guillén et al. Nutrients. .

Abstract

This cross-sectional study aims to explore the prevalence of protein-energy wasting (PEW) in dialysis patients in Catalonia, Spain, using a new and practical online tool which enables rapid calculation and comparison with other nutritional scores.

Methods: A web tool (Nutrendial) was created to introduce different variables and automatically calculate PEW, Malnutrition inflammation Score (MIS) and Subjective Global Assessment (SGA) in 1389 patients (88% in haemodialysis (HD)), 12% in peritoneal dialysis (PD) from different regions of Catalonia.

Results: A prevalence of 23.3% (26% HD, 10.2% PD) of PEW was found, with a mean MIS score of 6 and SGA score of C in 7% of the patients. ROC analysis showed MIS as the best nutritional score to diagnose PEW (AUC 0.85). Albumin delivered lower diagnostic precision (AUC 0.77) and sensitivity (66%). A cut off point of 7 (86% sensitivity and 75% specificity) for MIS and 3.7 mg/dL for albumin were found to predict the appearance of PEW in this population. SGA B or C showed an 87% sensitivity and 55% specificity to diagnose PEW. Very low nutritional intervention (14%) was recorded with this tool in patients with PEW.

Conclusions: This new online tool facilitated the calculation of PEW, enabling different professionals-including nephrologists, dieticians and nurses-to efficiently obtain insights into the nutritional status of the Catalonian dialysis population and implement the required nutritional interventions. MIS is the score with more sensitivity to diagnose PEW.

Keywords: dialysis; malnutrition inflammation score; nutritional assessment; online tool; protein-energy wasting; subjective global assessment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Data collection sheet.
Figure 2
Figure 2
Nutrendial Web Application. Icons drawn by Surang, Freepikcompany, Paulalee, Flat icons, Ultimatearm and Eucalyp from www.flaticon.com (accessed on 29 March 2022). Figures shown in results box are examples only.
Figure 3
Figure 3
(A) Receiver operating characteristic (ROC) curve for malnutrition inflammation score (MIS) for the diagnosis of protein-energy wasting (PEW). Area under the curve (AUC) for MIS is 0.85 with p < 0.001 (B) Aggregated receiver operating characteristic (ROC) curves for several malnutrition markers for the diagnosis of protein-energy wasting (PEW). Area under the curve (AUC) for every marker are detailed on Table 3. BMI, body max index; TIBC, total iron binding capacity.
See this image and copyright information in PMC

References

    1. Carrero J.J., Stenvinkel P., Cuppari L., Ikizler T.A., Kalantar-Zadeh K., Kaysen G., Mitch W.E., Price S.R., Wanner C., Wang A.Y., et al. Etiology of the Protein-Energy Wasting Syndrome in Chronic Kidney Disease: A Consensus Statement from the International Society of Renal Nutrition and Metabolism (ISRNM) J. Ren. Nutr. 2013;23:77–90. doi: 10.1053/j.jrn.2013.01.001. - DOI - PubMed
    1. Fouque D., Kalantar-Zadeh K., Kopple J., Cano N., Chauveau P., Cuppari L., Franch H., Guarnieri G., Ikizler T.A., Kaysen G., et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73:391–398. doi: 10.1038/sj.ki.5002585. - DOI - PubMed
    1. Kalantar-Zadeh K., Kopple J.D., Block G., Humphreys M.H. A malnutrition-inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. Am. J. Kidney Dis. 2001;38:1251–1263. doi: 10.1053/ajkd.2001.29222. - DOI - PubMed
    1. Enia G., Sicuso C., Alati G., Zoccali C., Pustorino D., Biondo A. Subjective global assessment of nutrition in dialysis patients. Nephrol. Dial. Transplant. 1993;8:1094–1098. doi: 10.1093/oxfordjournals.ndt.a092299. - DOI - PubMed
    1. Ikizler T.A. Optimal Nutrition in Hemodialysis Patients. Adv. Chronic Kidney Dis. 2013;20:181–189. doi: 10.1053/j.ackd.2012.12.002. - DOI - PMC - PubMed

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