Turkish Version of The Renal Inpatient Nutrition Screening Tool: Validity and Reliability for Hemodialysis Patients.

Abstract

The aim of this study was to analyze the validity and reliability of the Turkish version of the Renal Inpatient Nutrition Screening Tool (Renal iNUT) for hemodialysis patients.The Renal Inpatient Nutrition Screening Tool (Renal iNUT) and the Malnutrition Universal Screening Tool (MUST) were used in adult hemodialysis patients at two different centers to identify malnutrition. The Subjective Global Assessment (SGA), regarded as the gold standard for nutritional status assessment, was utilized for comparison. Structural validity was assessed using biochemical values and anthropometric measurements, while reliability was assessed using repeated the Renal iNUT assessment. Of the 260 patients admitted, 42.3% were malnourished (SGA score was B or C). According to the Renal iNUT, 59.6% of the patients were at increased risk for malnutrition (score ≥1) and 3.8% required referral to a dietitian (score ≥2). According to the MUST, 13.1% the of patients were at increased risk for malnutrition and 8.5% required referral to a dietician. The Renal iNUT was found to be more sensitive in detecting increased risk of malnutrition in hemodialysis patients compared with the MUST (59.6% versus 13.1%). According to the SGA, the sensitivity of the Renal iNUT is higher compared to the MUST (89% and 45%, respectively). Kappa-assessed reliability of the Renal iNUT was 0.48 (95% CI, 0.58-0.9) and a moderate concordance was observed. The Renal iNUT is a valid and reliable nutritional screening tool for evaluating hemodialysis patients to determine their nutritional status. The use of the Renal iNUT by dieticians will contribute to the identification of malnutrition and its treatment.