Malnutrition Score Research Articles

A Novel Nomogram for Early Identification and Intervention in Colorectal Cancer Patients at Risk for Malnutrition.

Malnutrition is under-recognized in cancer patients and can lead to poor treatment outcomes. We aim to develop an outpatient-focused score based on the Malnutrition Screening Tool (MST) to help identify colorectal cancer (CRC) profiles at high risk for malnutrition. 506 CRC patients during initial outpatient oncology consultation at our tertiary referral outpatient oncology clinic completed the MST. Objective and subjective data were collected through chart review. Data gathered are as follows: demographics, anthropometrics, laboratory values, patient-reported symptoms, MST score, cancer history, performance status, socioeconomic status, and Charlson Comorbidity. Predictors of malnutrition were identified by logistic regression. Receiver operating curve (ROC), area under the curve (AUC), and our model's predictability were determined. Significant predictors of malnutrition are as follows: younger age (20-39 vs >40 years) (P = .007), normal-to-low body mass index at presentation (P = .019), Eastern Cooperative Oncology Group classification 2-3 (P = .012), metastatic disease (P = .046), albumin <3.0g/dL (P = .033), fatigue (P < .001), and change in stool/bowel habits (P = .002). In our derived malnutrition score, risk of malnutrition increased from 11% for score 0, to 100% for scores 9-10. Receiver operating curve showed AUC .745 (95% CI, .697-.793). An outpatient clinic-derived malnutrition score obtained from objective and patient-reported variables may facilitate identification of CRC patients at highest risk for malnutrition. Rapid identification and intervention in high-risk patients may improve treatment recovery, therapy tolerance, and quality of life. Our tool requires external validation before application in clinical practice.

Use of the pediatric yorkhill malnutrition score screening tool in determining the malnutrition risk of hospitalized children

Rationale: This study aims to use the Pediatric Yorkhill Malnutrition Score (PYMS), which is a nutritional screening tool, in determining the malnutrition risk, which is very important to hospitalized children.

Estimating the time point for nutritional failure in patients suffering from acute brain attacks in the intensive care unit.

Severe brain attack patients demonstrate hypermetabolic state and gastrointestinal dysfunction, leading to faster onset of nutritional failure. To estimate the time point where the development of nutritional failure is more probable among patients with acute brain attacks in the intensive care unit (ICU). Direct bedside observation for selected nutritional parameters was performed. When enteral nutrition was initiated, observation was performed at five points over 9 days. 84 patients with 55% mortality risk and on mechanical ventilation were included. Over the observation period, gastric residual volume increased (144 ml vs 196 ml), body weight decreased (79.4 kg vs 74.3 kg), and serum albumin reduced (3.6 g/dl to 3.1 g/dl). Caloric attainment and malnutrition score deteriorated, and feeding-related complications increased. Nutritional failure was evidently prevalent between the third and fifth day of observation. An earlier period of enteral nutrition entails higher probability of nutritional failure among severe brain attack patients in the ICU.

PENGARUH PENYULUHAN PYMS (PEDIATRIC YORKHILL MALNUTRITION SCORE) TERHADAP PENGETAHUAN TENAGA KESEHATAN DI PUSKESMAS BIARO KABUPATEN AGAM

&lt;p&gt;&lt;em&gt;PYMS (Pediatric Yorkhill Malnutrition Score) is the most appropriate tool, efficient, feasible, easy to use, easy to integrate into clinical practice and requires a short time to detect nutritional status in toddlers. The purpose of this study was to determine the effect of PYMS (Paediatric Yorkhill Malnutrition Score) counseling on the knowledge of health workers at the Biaro Health Center, Agam Regency.&lt;/em&gt; &lt;em&gt;The population in this study were health workers at the Biro Public Health Center with a total sampling of 27 health workers. This type of research uses a one group pre-test and post-test design without control. Data collection is carried out directly on the respondents by using a questionnaire. Data processing for bivariate analysis with Wilcoxon test. The results of the univariate analysis showed that before being given counseling, more than half had sufficient knowledge as many as 14 (51.9%), and after being given counseling that more than half had good knowledge were 14 (51.9%). The results of bivariate analysis with the Wilcoxon test obtained p-value 0.000 or p &amp;lt;0.05, thus there is an influence of knowledge on counseling. With the understanding of health workers on the use of PYMS (Pediatric Yorkhill Malnutrition Score).&lt;/em&gt;&lt;/p&gt;

Prevalence and Prognostic Significance of Malnutrition Risk in Patients With Acute Ischemic Stroke: Results From the Third China National Stroke Registry.

To investigate the prevalence of malnutrition risk in patients with acute ischemic stroke (AIS) at admission, the association between malnutrition risk and long-term outcomes, and whether the predictive ability would be improved after adding to previous prognostic models for poor outcomes. Based on the Third China National Stroke Registry data from August 2015 to March 2018, we evaluated malnutrition risk using objective scores, including the controlling nutritional status score, geriatric nutritional risk index, and prognostic nutritional index. The primary outcome was death or major disability (modified Rankin Scale score ≥3) at 1 year after stroke onset. We calculated the crude prevalence of malnutrition risk and investigated the association between malnutrition risk and clinical outcomes. Prognostic performance of 3 objective malnutrition scores for poor outcomes was assessed. Moderate to severe malnutrition risk was identified in 5.89%, 5.30%, and 1.95% of the Third China National Stroke Registry AIS patients according to the controlling nutritional status score, geriatric nutritional risk index, and prognostic nutritional index, respectively. At 1-year follow-up, 1143 participants (13.5%) experienced death or major disability. After adjustment for traditional risk factors, moderate to severe malnutrition risk was associated with high risk of composite events (odds ratio, 2.25 [95% CI, 1.75-2.90], for controlling nutritional status score; odds ratio, 2.10 [95% CI, 1.63-2.69], for geriatric nutritional risk index; odds ratio, 3.36 [95% CI, 2.33-4.84], for prognostic nutritional index; all P<0.01). Addition of the 3 malnutrition scores to different predicted scales (iScore and Acute Stroke Registry and Analysis of Lausanne) improved predictive ability for long-term poor outcomes validated by the integrated discrimination index (all P<0.05). The prevalence of moderate or severe malnutrition risk in Chinese patients with AIS ranged from 1.95% to 5.89%. Malnutrition risk in patients with AIS was associated with increased risk of long-term death and major disability. Our study provides evidence supporting the prognostic significance of objective malnutrition scores after AIS.

The effect of French maritime pine bark extract supplementation on inflammation, nutritional and clinical status in critically ill patients with traumatic brain injury: A randomized controlled trial.

Inflammation plays an important role in the pathophysiology of traumatic brain injury (TBI). Based on the anti-inflammatory properties of French maritime pine bark extract and the neuroprotective effects, we aimed to evaluate the effects of its supplementation on TBI. Sixty-seven TBI patients admitted to the intensive care units (ICUs) were enrolled. After stabilizing the hemodynamic status, the intervention group received 150 mg of French maritime pine bark extract supplementation (Oligopin) with enteral nutrition for 10 days. The control group received a placebo. Inflammatory status and oxidative stress markers were measured three times. Also, clinical and nutritional statuses were assessed. Supplementation, significantly decreased IL-6 (β= -53.43 pg/ml, 95% confidence interval [CI]=-91.74, -15.13, p= .006), IL-1β (β= -111.66 pg/ml, 95% CI=-183.79, -39.5402, p= .002) and C-reactive protein (β= -19.99 mg/L, 95% CI=-27.23, -12.76, p˃.001) in the intervention group compared to control group after 10 days. Clinical scores including acute physiology and chronic health evaluation II and sequential organ failure assessment were reduced (β= -3.72, 95% CI=-5.96, -1.49, p= .001and β= -2.07, 95% CI=-3.23, -0.90, p< .001, respectively), and Nutric score was reduced compared to control group (β= -.60, 95% CI=-1.08, -0.12, p= .01). The survival rate was higher by 15% in the intervention group compared to control group. Oligopin supplementation in TBI patients in ICU reduced inflammation and improved the clinical status and malnutrition score and thereby reducing the mortality rate.

Status gizi berdasarkan dialysis malnutrition score (DMS) dengan kualitas hidup pasien hemodialisis

Nutritional status based on the dialysis malnutrition score (DMS) with hemodialysis patients' quality of lifeBackground: Chronic kidney disease (CKD) is a disorder of the kidney organs characterized by abnormalities in the structure or function of the kidneys. Patients suffering from end-stage CKD require renal replacement therapy in the form of hemodialysis. However, hemodialysis on a routine basis can decrease nutritional status, which will result in malnutrition patients. Malnutrition is associated with morbidity and mortality rates, such as prolonged weakness, susceptibility to infectious diseases, and impaired wound healing that can affect the quality of life. Objective: This study aims to determine the correlation between nutritional status based on the Dialysis Malnutrition Score (DMS) with the quality of life of hemodialysis patients. Methods: The research design was cross-sectional with an observational research design. This research was conducted from 02 September 2019 until 11 September 2019 in the hemodialysis unit at RSUD Panembahan Senopati Bantul with 182 subjects of all chronic kidney disease patients undergoing hemodialysis from 2009 until April 2019. The researcher assessed nutritional status data based on the DMS. In addition, the quality of life was based on Kidney Disease Quality of Life (KDQoL) which researchers for elderly subjects assisted, and some parts filled directly by the subject. The statistical analysis used for this study was the Chi-square test. Results: Based on the Chi-square test, there is a correlation between nutritional status based on the DMS and the quality of life of hemodialysis patients (p-value=0.009). Most subjects had good nutritional status based on the DMS and had good quality on the KDQoL. Conclusions: There is a correlation between the risk of malnutrition based on the Dialysis Malnutrition Score (DMS) and hemodialysis patients' quality of life (KDQoL).

Relationship Between Left Atrial Strain and Malnutrition Scores in Diabetic Patients

Objectives: Malnutrition is a serious public health problem that is associated with adverse outcomes in a broad range of disease including cardiovascular disease and diabetes mellitus. Malnutrition is demonstrated to be accompanying to several disease, yet there is a lack of evidence on the impact of malnutrition on cardiac functions in patients with diabetic patients with diabetic retinopathy. Herewith our primary goal was to evaluate the relation between any degree malnutrition with left atrial strain in relevant patient group. Patients and Methods: Patients with diabetes mellitus with retinopathy, who were referred to the outpatient cardiology clinic were assessed. Those who had sinus rhythm, had no findings of significant valvular heart disease and coronary artery disease underwent to 2-dimensional speckle tracking echocardiography and assessed for malnutrition in their prior examinations were included to the study. Hundred and seventy patients met the inclusion criteria. Malnutrition scores such as CONUT score, NRI, and PNI were used to evaluate nutrition condition of the patients. Results: Thirty percent of all diabetic patients were demonstrated to have malnutrition according to the CONUT score. Left atrial conduit strain was demonstrated to decrease [ß: -7.5 (CI 95%, -10.7, -4.3 p&lt;0.001)], Left atrial reservoir strain was demonstrated to increase [ß: 2.48(CI 95%,0.83- 4.13 p&lt;0.03)] and Left atrial contractile strain was demonstrated to decrease [ß: -4.21(CI 95%, -2.21, -6.01 p&lt;0.001)] in the presence of any degree malnutrition. Conclusion: In this study we have demonstrated that malnutrition is an important entity in patients with diabetes mellitus and also has a significant impact on Left atrial strain.

Optimal Nutritional Factors Influencing the Duration of Mechanical Ventilation Among Adult Patients with Critical Illnesses in an Intensive Care Unit.

ObjectiveThis study aims to identify the impact of nutritional factors on mechanical ventilation duration for critical patients.Patients and MethodsThe current study was a single-center, prospective observational design which enrolled one-hundred critically ill patients who were admitted to an intensive care unit (ICU). It demonstrates purposive sampling and also performs the descriptive nutritional factors influencing the mechanical ventilation duration. Daily calories target requirement scale (DCRS), subjective global assessment form (SGA), dyspnea assessment form, and APACHE II have been used as methods in the study along with time to initial enteral nutrition (EN) after 24-hour admission and daily calories target requirement over 7 days to assess patients. Data is analyzed using the multiple regressions.ResultsAs a result, nutritional status monitoring, time to initial EN, calories and target requirements are statistically positive significance associated with the mechanical ventilation duration respectively (R = 0.54, R = 0.30, R= 0.40, p < 0.05). However, age, illness severity, and dyspnea scales are not associated with the mechanical ventilation duration (p> 0.05). Therefore, the nutritional status, malnutrition scores and calorie target requirements can be used to significantly predict the mechanical ventilation duration. The predictive power is 58 and 28.0% of variance. The most proper influencer to predict the mechanical ventilation duration is nutritional status or malnutrition scores.ConclusionThe research findings show that the nutritional status, time to initial EN, and calorie target requirement within 7 days of admission are associated with the mechanical ventilation duration in the critical patients. Therefore, it can be used to develop guidelines reducing the mechanical ventilation duration and to promote the ventilator halting for critical patients.

MO700EPIDEMIOLOGICAL ADMISSIONS IN PERITONEAL DIALYSIS IN A SINGLE DIALYSIS CENTER

Abstract Background and Aims The knowledge of the impact of peritoneal dialysis (PD) program in terms of hospitalization rate can provide solid guidance for nephrologists for management purpose. In a historical cohort of adult PD patients, we examined the hospitalization rates and causes of hospital admissions. Method One hundred ninety-one consecutive PD patients between January 1st 2000 to December 31st 2018 were enrolled. The maximum follow up was 194 months. Their mean age was 65±15 years, 110 were males, 56 had co-morbidities and 67 were diabetics. The median PD vintage was 35 months (interquartile range 20-63 months). Results During the follow-up, 163 out of 191 patients (85%) underwent hospital admission for a total of 356 hospitalizations [57 hospitalizations per 100-person-years]. The most frequent cause of admission was infection (20 hospitalizations per 100-person-years) mainly due to peritonitis (12 hospitalizations per 100-person-years) followed by cardiovascular diseases (17 hospitalizations per 100-person-years). Hospitalizations due to miscellaneous causes were 21 per 100-person-years. In the whole group, high NYHA score [Incidence Rate Ratio (IRR): 1.52, 95%CI 1.21-1.89, P&amp;lt;0.001], residual diuresis &amp;lt;500 ml/die (IRR: 1.43, 95%CI 1.13-1.82, P=0.002), malnutrition (IRR: 1.47, 95%CI 1.08-1.99, P=0.01) and older age (&amp;gt;65 years) (IRR 1.26, 95%CI 1.02-1.56, P=0.03) and were associated to all-cause hospitalizations. In an analysis by hospitalization type, the factors related to admission for infection diseases was malnutrition (IRR: 1.91, 95%CI 1.16-3.03, P=0.005) and high NYHA score (IRR: 1.52, 95%CI 1.03-2.22, P=0.02). As expected, hospitalizations due to cardiovascular causes were strongly related to older age (&amp;gt;65 years) (IRR 2.02, 95%CI 1.35-3.03, P&amp;lt;0.001), diabetes (IRR 2.13, 95%CI 1.43-3.18, P&amp;lt;0.001), high NYHA score (IR 2.14, 95%CI 1.43-3.21, P=0.001], residual diuresis &amp;lt;500 ml/die (IRR: 1.65, 95%CI 1.06-2.55, P=0.02) and previous cardiovascular events (IRR: 1.50, 95%CI 0.98-2.25, P=0.05). Conclusion Analyzing the causes and the rate of hospitalization in PD patients allows more accurate management of these high risk category of patients and contributes to a more efficient organization of a renal department.

Nutritional Status of Patients on Maintenance Hemodialysis at Muhimbili National Hospital in Dar es Salaam, Tanzania: A Cross-Sectional Study.

Background Patients on hemodialysis therapy are at high risk of malnutrition which is attributed to multiple factors. Protein-energy malnutrition in these patients confers poor clinical outcomes. This study investigated the nutritional status of patients on maintenance hemodialysis at Muhimbili National Hospital in Dar es Salaam, Tanzania. Methods A cross-sectional descriptive study was done among 160 adult patients on maintenance hemodialysis therapy. Data concerning patients' personal, medical, dietary, and hemodialysis-related information were collected. Patients' anthropometric and laboratory tests (complete blood count, albumin, total cholesterol, creatinine, and urea) were measured. The quantitative Subjective Global Assessment (SGA) dialysis malnutrition score (DMS) was used to assess their nutritional status. Data analysis was done using the SPSS software version 20. Results Among the 160 hemodialysis patients, 49 (30.6%) were female. Patients' mean age was 52.2 ± 13.3 years. The median duration on hemodialysis was 18 (8.25–29.75) months. Malnutrition was present in 98 (61.2%) of the patients. Severe malnutrition was found in only 3 (1.9%) patients and 16.9% were underweight. The longer duration on hemodialysis, having diabetes mellitus, and being single were associated with increased risk for malnutrition in multivariate logistic regression. Malnourished patients had significantly lower dry weight, body mass index, mid-upper arm circumference, waist circumference, albumin, total cholesterol, and creatinine levels. Conclusion Malnutrition is very common among hemodialysis patients at Muhimbili National Hospital, especially those on longer duration of hemodialysis, and diabetic patients. We recommend that hemodialysis patients should be regularly assessed for malnutrition and appropriately treated which if left unattended heralds worse outcomes.

Prognostic significance of malnutrition scores in elderly patients for the prediction of contrast-induced acute kidney injury.

Malnutrition reflects the general condition of a patient including physical condition, protein turnover, and immune competence. Contrast-induced acute kidney injury (CI-AKI) is a disorder that adversely affects the prognosis of older adults. In our study, we aimed to show the relationship between CI-AKI and malnutrition status in elderly patients over 65years of age with chronic coronary artery disease (CAD). Study enrolled 360 consecutive patients with coronary angiography performed because of chronic coronary artery disease. Patients pre-procedural and post-procedural blood samples were taken and prognostic nutritional index (PNI), controlling nutritional status (CONUT) score, and geriatric nutritional risk index (GNRI) malnutrition scores were calculated. The median age of the patients included in the study was 69 (67-72, IQR) and CI-AKI was seen in 91 (25.2%) patients. Univariate regression analysis showed that age, diabetes mellitus, baseline creatinine, body weight-adapted contrast agent, haemoglobin, left ventricular ejection fraction, CONUT score, PNI score, and GNRI score were independent predictors of CI-AKI. In model 1, increase in CONUT score (2 to 5) (OR: 3.21 (2.11-4.88), in model 2, increase in PNI score (37.4 to 45) (OR: 0.34, (0.24-0.49)), and in model 3, increase in GNRI score (89.5 to 103.8) (OR: 0.55, (0.38-0.81)) were independently associated with the presence of CI-AKI. PNI showed better results than other models in discriminating the predictable capability for CI-AKI. Malnutrition assessment of elderly patients before performing diagnostic or interventional coronary procedures could help clinicians to identify patients with elevated risk for CI-AKI.

Do Malnutrition Scores Have a Role in Prediction of Non-dipper Hypertension?

Do Malnutrition Scores Have a Role in Prediction of Non-dipper Hypertension?

Assessment of Factors Related to Diminished Appetite in Hemodialysis Patients with a New Adapted and Validated Questionnaire.

Appetite loss is a common phenomenon in end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (HD). We aimed to (i) adapt and validate a Spanish language version of the Council on Nutrition Appetite Questionnaire (CNAQ) and (ii) to identify psychological and biological factors associated with diminished appetite. We recruited 242 patients undergoing HD from four hemodialysis centers to validate the Spanish-translated version of the CNAQ. In another set of 182 patients from three HD centers, the Appetite and Diet Assessment Tool (ADAT) was used as the gold standard to identify a cut-off value for diminished appetite in our adapted questionnaire. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Distorted Thoughts Scale (DTS), Dialysis Malnutrition Score (DMS), anthropometric, values and laboratory values were also measured. Seven items were preserved in the adapted appetite questionnaire, with two factors associated with flavor and gastric fullness (Cronbach’s alpha = 0.758). Diminished appetite was identified with a cut-off value ≤25 points (sensitivity 73%, specificity 77%). Patients with diminished appetite had a higher proportion of females and DMS punctuation, lower plasmatic level of creatinine, blood urea nitrogen, and phosphorus. Appetite score correlated with BDI score, BAI score and DTS. Conclusions: This simple but robust appetite score adequately discriminates against patients with diminished appetite. Screening and treatment of psychological conditions may be useful to increase appetite and the nutritional status of these patients.

Malnutrition in Hospitalised Children-An Evaluation of the Efficacy of Two Nutritional Screening Tools.

Nutritional risk screening (NRS) is not yet established in many clinical settings. This study aimed to evaluate the efficacy of two NRS tools; the Paediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), compared to the global dietitians’ clinical judgment. The goal of this study was also to estimate the prevalence of nutritional risk in Greek paediatric patients. Overall, 1506 children, 1–16 years, from paediatric and surgical wards of two Greek hospitals were included. NRS was performed using PYMS and STAMP based either on World Health Organization (WHOGC) or Hellenic growth charts (HGC). The first 907 children were also referred to dietitians who categorized children in low, medium and high nutritional risk according to their global clinical judgment. PYMS, either based on WHOGC or HGC, showed better agreement with dietitians’ feedback (kPYMS_WHO = 0.47; 95%CI: 0.41–0.52, kPYMS_HGC = 0.48; 95%CI: 0.43–0.53) compared to STAMP (kSTAMP_WHO = 0.28; 95%CI: 0.23–0.33, kSTAMP_HGC = 0.26; 95%CI: 0.21–0.32). PYMS also showed the best diagnostic accuracy compared to STAMP in paediatrics and surgical wards separately. Moreover, the PYMS showed similar sensitivity to the STAMP (WHOGC: 82% vs. 84.4%), but a higher positive predictive value (WHOGC: 58.2 vs. 38.7). Using PYMS, high and medium malnutrition risk was observed at 14.9%, and 13.1% of children, respectively. Almost 28% of hospitalised children were at nutritional risk. Children in hospitals should be screened with effective and feasible NRS tools such as PYMS.

Serum Adropin Levels in Patients on Hemodialysis.

Adropin is a novel pleotropic peptide involved in energy homeostasis, with possible contribution to cardiovascular protection through production of nitric oxide and subsequent blood pressure regulation. Given that patients undergoing hemodialysis (HD) are related with high cardiovascular risk, hyperlipidemia, chronic low-grade inflammation, and malnutrition the aim of our study was to investigate serum adropin levels in HD patients to evaluate possible associations with nutritional status and other relevant clinical and laboratory parameters. The study included 70 patients on HD and 60 healthy controls. Serum adropin levels were determined by an enzyme-linked immunosorbent assay in a commercially available diagnostic kit. Serum adropin levels were significantly lower in the HD group compared to the control group (2.20 ± 0.72 vs. 4.05 ± 0.93 ng/mL, p < 0.001). Moreover, there was a significant negative correlation with malnutrition-inflammation score (r = −0.476, p < 0.001), dialysis malnutrition score (r = −0.350, p = 0.003), HD duration (r = −0.305, p = 0.010), and high sensitivity C-reactive protein (hsCRP) (r = −0.646, p < 0.001). Additionally, there was a significant negative correlation between adropin levels and pre-dialysis systolic (r = −0.301, p = 0.011) and diastolic blood pressure (r = −0.299, p = 0.011). These results are implying that adropin is potentially involved in the pathophysiological mechanisms of chronic kidney disease (CKD)/HD and its complications. However, future larger scale longitudinal studies need to further address it.

Evaluation of nutritional status of regular hemodialysis elderly patients using modified subjective global assessment score

Background Malnutrition, an important problem in geriatric medicine, is becoming more recognized in hemodialysis patients, as a factor that can even worsen the prognosis and the quality of life of these patients. It is imperative for the nephrology community to recognize this syndrome of malnutrition and work to manage it. Malnutrition can be detected commonly in all age groups of dialysis patients, and it represents a sensitive marker for morbidity and mortality better than chronological age. It could also act as a major cofactor for depression and cognitive impairment development in dialysis patients. We aimed to assess the nutritive status of the elderly patients with end-stage renal disease (ESRD) undergoing hemodialysis using modified subjective global assessment score (M-SGAS) and to correlate between it and different biochemical parameters. Patients and methods A total of 100 ESRD elderly patients on regular hemodialysis were included. All patients were subjected to the following: history taking, including weight change, dietary intake, gastrointestinal symptoms, and functional capacity (nutritionally related functional impairments, comorbidity); physical examination, including decreased fat stores or loss of subcutaneous fat (eyes, triceps, biceps, and chest), signs of muscle wasting (temple, clavicle, ribs, knee, interosseous, quadriceps, and scapula), mid-upper arm and calf circumference, and BMI; malnutrition score (sum of all number) using SGAS; and laboratory investigations, including complete blood count, serum creatinine, blood urea, C-reactive protein, serum albumin, parathyroid hormone, serum calcium, serum phosphorus. urea reduction ratio, and KT/V. Results There was a decrease in anthropometric measures in both males and females, indicating that both sexes are prone to malnutrition to the same degree. On comparing between male and female patients with respect to total M-SGAS, they lie in the moderate degree of total M-SGAS, with no significant difference between males and females. There was a statistically significant negative correlation between M-SGAS and triceps skin fold, mid-arm muscle circumference, and mid-arm circumference, and also there was a statistically significant negative correlation between duration of dialysis and mid-arm circumference. Conclusion The M-SGAS can be used as reliable, rapid, and precise method for nutritional assessment in elderly patients with ESRD on regular hemodialysis. There is a high prevalence of malnutrition among all age groups, even those younger than 40 years old. Malnutrition is associated with female sex, hypoalbuminemia, increased inflammatory markers such as elevated C-reactive protein and elevated total leukocytic count, and in those with low hemoglobin level. Malnutrition also is more detected in patients with hyperparathyroidism.

Plasma Catestatin Levels and Advanced Glycation End Products in Patients on Hemodialysis.

Catestatin (CST) is a pleiotropic peptide involved in cardiovascular protection with its antihypertensive and angiogenic effects. Considering that patients with end-stage renal disease (ESRD) who are undergoing hemodialysis (HD) are associated with higher cardiovascular risk, the aim of this study was to investigate plasma CST levels in HD patients, compare them to healthy controls and evaluate possible CST associations with advanced glycation end products (AGEs) and laboratory, anthropometric and clinical parameters. The study included 91 patients on HD and 70 healthy controls. Plasma CST levels were determined by an enzyme-linked immunosorbent assay in a commercially available diagnostic kit, while AGEs were determined using skin autofluorescence. Plasma CST levels were significantly higher in the HD group compared to the controls (32.85 ± 20.18 vs. 5.39 ± 1.24 ng/mL, p < 0.001) and there was a significant positive correlation between CST and AGEs (r = 0.492, p < 0.001). Furthermore, there was a significant positive correlation between plasma CST levels with both the Dialysis Malnutrition Score (r = 0.295, p = 0.004) and Malnutrition-Inflammation Score (r = 0.290, p = 0.005). These results suggest that CST could be playing a role in the complex pathophysiology of ESRD/HD and that it could affect the higher cardiovascular risk of patients on HD.

Malnutrition score and Body Mass Index as nutritional screening tools for hemodialysis patients.

Malnutrition is highly prevalent in the hemodialysis population. Nutritional screening is important to identify patients at risk of malnutrition. This study aimed to investigate the concurrent validity of BMI cut-offs (BMI<23kg/m2 and BMI<18.5kg/m2) and DMS, as simple nutritional screening tools, compared to PG-SGA, as the reference standard, in detecting the risk of malnutrition in hemodialysis patients. A Single-centered cross-sectional study design. A total of 98 patients on maintenance hemodialysis, who were at least 18 years old (mean age: 51.33±14.12) and subjected to hemodialysis for at least 3 months, were screened. Concurrent validity was assessed using receiver operating characteristic (ROC) curve analysis as well as sensitivity, specificity, accuracy, PPV, NPV, LR+ and LR-, against diagnosed malnutrition. The patients considered malnourished were 71.4% (n=70), with the majority being females (60%), and possessed a BMI distribution of 28.2±6.3kg/m2. DMS (score≥14) agreed with diagnosed malnutrition (κ=0.450 (95% CI 0.26-0.64) <0.0005). Furthermore, DMS (score≥14) showed a sensitivity and a specificity of 84.3% and 60.7%, respectively. However, BMI cut-offs (<23kg/m2 or<18.5kg/m2) did not show any agreement with diagnosed malnutrition. DMS is a useful screening tool for detecting the risk of malnutrition in hemodialysis patients. On the contrary, BMI <23kg/m2 and BMI <18.5kg/m2 were not valid tools for identifying the risk of malnutrition in hemodialysis patients.

Comparison of malnutrition and malnutrition screening tools in pediatric oncology patients: A cross-sectional study

ObjectivesThe aim of this study was to determine the prevalence of malnutrition, to compare nutritional evaluation tools, and to highlight the importance of nutritional status in pediatric oncology patients. MethodsThis study evaluated the nutritional status, based on height, weight, and midupper arm circumference, of 170 patients ages 5 months to 18 years who were hospitalized at the Ege University Hospital Pediatric Oncology Clinic. The prevalence of malnutrition was determined using the malnutrition screening tools, STRONGkids (SK) and Pediatric Yorkhill Malnutrition Score (PYMS). Correlations, sensitivity, specificity, and the positive and negative predictive values between the screening tools were calculated. ResultsIn all, 68.2% of the patients were diagnosed with a solid tumor. According to SK, 59.4% had a moderate risk of malnutrition, and 40.6% had a high risk. According to PYMS, 30.6% of patients had a low to moderate risk of malnutrition, and 69.4% had a high risk of malnutrition. Minimal agreement was noted between SK and PYMS (Kappa value: 0.40 and 0.18, respectively). The sensitivity of PYMS was higher than that of SK (92.68 and 78.05, respectively). In total, 22.9% of the patients had a body mass index of <5%, and 21.2% had a midupper arm circumference of <5. ConclusionsThe present findings show that, in general, pediatric oncology patients have a high risk of malnutrition. Although SK and PYMS do not differ significantly, PYMS has higher sensitivity for detecting malnutrition. The nutritional status of pediatric oncology patients should be monitored using appropriate screening techniques throughout their treatment.