#1349 Importance of malnutrition and frailty in kidney transplant waiting list

Abstract

Abstract Background and Aims Malnutrition and frailty predict postoperative complications. Recently, in an effort to assess nutritional status modified quantitative subjective global assessment (QSGA) systems have been devised in which scores are assigned for items or components of the SGA. This prospective study evaluated relationship QSGA and frailty assessment methods in patients waiting for kidney transplantation. Method We operated a fully quantitative scoring system consisting of 7 variables: weight changes, dietary intake, gastrointestinal symptoms, functional capacity, comorbidity, subcutaneous fat, and sign of muscle wasting. Each component was assigned a score from 1 (normal) to 5 (very severe). The sum of all seven components in this malnutrition score lies between 7 (normal) and 35 (severely malnourished). To evaluate frailty status, Short Physical Performance Battery (SPPB), Revised Risk Analysis Index (RAI), Karnofsky Frailty Score, Hand Grip Strength (HGS) methods were used. Three hundred and sixty patients (143 women and 217 men) were randomly selected from kidney transplant waiting list. Patients were aged between 21 and 82 years (56 ± 12.8) and had undergone hemodialysis for between 0 and 240 months (33.3 ± 34.6). Results The malnutrition score of each patient was assessed by a dietitian within 5-10 min. Pearson correlation coefficients showed positive correlation between the QSGA score and duration of hemodialysis (r = +0.52), age (r = +0.21), EPTS (+0.29) and RAI ((+0.25). QSGA showed negative correlation with Karnofsky score (r = −.30), SPPB (r = −.40), HGS (r = −.20). Multiple regression analysis showed a significant correlation between QSGA score and the combination of duration of hemodialysis, severity of RAI index, BMI and SPPB (R2 = 0.32, p = 0.00). Conclusion In addition to frailty assessment, the QSGA system may be additional method for evaluation of patients on the kidney transplant waiting list. More comparative studies are required to confirm the validity of this scoring system in nutritional evaluation of renal transplant candidates.