Dialysis malnutrition and malnutrition inflammation scores: Screening tools for prediction of dialysis - related protein-energy wasting in Malaysia

Gilcharan Singh Harvinder, Winnie Chee Siew Swee, Tilakavati Karupaiah, Sharmela Sahathevan, Karuthan Chinna, Ghazali Ahmad, Sunita Bavanandan, Bak Leong Goh

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background and Objectives: Malnutrition is highly prevalent in Malaysian dialysis patients and there is a need for a valid screening tool for early identification and management. This cross-sectional study aims to examine the sensitivity of the Dialysis Malnutrition Score (DMS) and Malnutrition Inflammation Score (MIS) tools in predicting protein-energy wasting (PEW) among Malaysian dialysis patients. Methods and Study Design: A total of 155 haemodialysis (HD) and 90 peritoneal dialysis (PD) patients were screened for risk of malnutrition using DMS and MIS and comparisons were made with established guidelines by International Society of Renal Nutrition and Metabolism (ISRNM) for PEW. Results: MIS cut-offscore of ≥5 indicated presence of malnutrition in all patients. A total of 59% of HD and 83% of PD patients had PEW by ISRNM criteria. Based on DMS, 73% of HD and 71% of PD patients exhibited moderate malnutrition, whilst using MIS, 88% and 90%, respectively were malnourished. DMS and MIS correlated significantly in HD (r2=0.552, p <0.001) and PD (r2=0.466, p <0.001) patients. DMS and MIS had higher sensitivity values in PD (81% and 82%, respectively) compared to HD (59% and 60%, respectively) patients. Conclusions: The MIS cut-offscores for malnutrition classification were established (score ≥5) for use amongst Malaysian dialysis patients. Both DMS and MIS are valid tools to be used for nutrition screening of dialysis patients especially those undergoing peritoneal dialysis. The DMS may be a more practical and simpler tool to be utilized in the Malaysian dialysis settings as it does not require laboratory markers.

Original languageEnglish
Pages (from-to)26-33
Number of pages8
JournalAsia Pacific Journal of Clinical Nutrition
Volume25
Issue number1
DOIs
Publication statusPublished - 1 Mar 2016

Fingerprint

Malaysia
Malnutrition
Dialysis
Inflammation
Proteins
Peritoneal Dialysis
Renal Dialysis

Keywords

  • Dialysis
  • Dialysis Malnutrition Score
  • Malnutrition Inflammation Score
  • Nutritional assessment
  • Protein-energy malnutrition

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Dialysis malnutrition and malnutrition inflammation scores : Screening tools for prediction of dialysis - related protein-energy wasting in Malaysia. / Harvinder, Gilcharan Singh; Swee, Winnie Chee Siew; Karupaiah, Tilakavati; Sahathevan, Sharmela; Chinna, Karuthan; Ahmad, Ghazali; Bavanandan, Sunita; Goh, Bak Leong.

In: Asia Pacific Journal of Clinical Nutrition, Vol. 25, No. 1, 01.03.2016, p. 26-33.

Research output: Contribution to journalArticle

Harvinder, Gilcharan Singh ; Swee, Winnie Chee Siew ; Karupaiah, Tilakavati ; Sahathevan, Sharmela ; Chinna, Karuthan ; Ahmad, Ghazali ; Bavanandan, Sunita ; Goh, Bak Leong. / Dialysis malnutrition and malnutrition inflammation scores : Screening tools for prediction of dialysis - related protein-energy wasting in Malaysia. In: Asia Pacific Journal of Clinical Nutrition. 2016 ; Vol. 25, No. 1. pp. 26-33.
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AU - Swee, Winnie Chee Siew

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AU - Sahathevan, Sharmela

AU - Chinna, Karuthan

AU - Ahmad, Ghazali

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AB - Background and Objectives: Malnutrition is highly prevalent in Malaysian dialysis patients and there is a need for a valid screening tool for early identification and management. This cross-sectional study aims to examine the sensitivity of the Dialysis Malnutrition Score (DMS) and Malnutrition Inflammation Score (MIS) tools in predicting protein-energy wasting (PEW) among Malaysian dialysis patients. Methods and Study Design: A total of 155 haemodialysis (HD) and 90 peritoneal dialysis (PD) patients were screened for risk of malnutrition using DMS and MIS and comparisons were made with established guidelines by International Society of Renal Nutrition and Metabolism (ISRNM) for PEW. Results: MIS cut-offscore of ≥5 indicated presence of malnutrition in all patients. A total of 59% of HD and 83% of PD patients had PEW by ISRNM criteria. Based on DMS, 73% of HD and 71% of PD patients exhibited moderate malnutrition, whilst using MIS, 88% and 90%, respectively were malnourished. DMS and MIS correlated significantly in HD (r2=0.552, p <0.001) and PD (r2=0.466, p <0.001) patients. DMS and MIS had higher sensitivity values in PD (81% and 82%, respectively) compared to HD (59% and 60%, respectively) patients. Conclusions: The MIS cut-offscores for malnutrition classification were established (score ≥5) for use amongst Malaysian dialysis patients. Both DMS and MIS are valid tools to be used for nutrition screening of dialysis patients especially those undergoing peritoneal dialysis. The DMS may be a more practical and simpler tool to be utilized in the Malaysian dialysis settings as it does not require laboratory markers.

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