Abstract
ObjectiveIn this study, we evaluated mini nutritional assessment (MNA) as a tool for the assessment of the nutritional status of end-stage renal disease (ESRD) patients on maintenance hemodialysis (MHD).MethodsThis prospective cross-sectional study was done from February 2021 till August 2021 on ESRD patients on MHD at our center. Nutritional status was assessed by using MNA score which evaluates four different aspects: anthropometric measures (body mass index [BMI], weight loss, mid-arm and mid-calf circumferences); general assessment (lifestyle, medications, mobility, and signs of depression); short dietary assessment (number of meals, food, and fluid intake) and subjective assessment (self-perception of food and nutrition).ResultsOut of 195 study subjects, 127 (65.1%) were males and 68 (34.9%) were females. Most women were stay-at-home mothers (57, 29.2% overall and 83.8% among all women), while most men owned their own businesses (44, 22.6% overall). The mean age was 51.2±14 years and the mean duration of hemodialysis was 4.6±4.1 years. Most of our patients belonged to the middle socioeconomic group (110, 56.6%). By using MNA, we found that most are at risk of developing malnutrition (112, 57.4%); however, only 9 (4.6%) patients are malnourished. In our study group, most malnourished patients belonged to the age group of >65 years (5, 56.6%). BMI was found to be significantly associated with MNA (p <0.001).ConclusionMNA is an easy and reliable bedside tool that can be used in ESRD patients on MHD for nutritional assessment. This is helpful in nutritional planning and the prevention of malnutrition.
Highlights
Chronic kidney disease (CKD) is a major public health problem, affecting over 109.9 million people from high-income countries (48.3 million men and 61.7 million women) and 387.5 million from lower-middleincome countries (177.4 million men and 210.1 million women) [1]
By using mini nutritional assessment score (MNA), we found that most are at risk of developing malnutrition (112, 57.4%); only 9 (4.6%) patients are malnourished
Body mass index (BMI) was found to be significantly associated with MNA (p
Summary
Chronic kidney disease (CKD) is a major public health problem, affecting over 109.9 million people from high-income countries (48.3 million men and 61.7 million women) and 387.5 million from lower-middleincome countries (177.4 million men and 210.1 million women) [1]. Protein energy wasting (PEW) is a frequent finding in patients on maintenance hemodialysis (MHD) with a global prevalence of 28-54% [2], associated with high morbidity and mortality [3,4]. It adversely affects patients' quality of life (QOL) [5,6]. Multiple factors contribute to the development of PEW in MHD patients including losses of amino acids and nutrients, dialysis-induced muscle catabolism, increased energy expenditure, resistance to anabolic hormones, ineffective correction of metabolic acidosis, inadequate dialysis, poor appetite, taste alterations, suboptimal dietary intake, insulin resistance, psychological factors, decreased functional capacity, depression and lack of social support [7]. Different methods of nutritional assessment are used include anthropometric measurements (body mass index [BMI], triceps skin fold thickness [TSFT], mid-arm muscle circumference [MAMC] and hand grip strength [HGS]), bio-impedance, subjective global assessment (SGA) and mini nutritional assessment score (MNA) [8,9]
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