ASSESSMENT OF MALNUTRITION IN AN INCENTRE HAEMODIALYSIS UNIT- SINGLE CENTRE EXPERIENCE

Malnutrition is highly prevalent among haemodialysis patients, but the best method for assessing nutritional status remains unclear. Historically, Dietitians’ use the Subjective Global Assessment (SGA) or Patient Generated Subjective Global Assessment (PG-SGA) tool to assess nutritional status of in centre haemodialysis patients. In 2001 a new tool called the Malnutrition Inflammation Score (MIS) was developed by Zadeh et al. We conducted an annual malnutrition audit on patients who regularly attend the in-centre haemodialysis units at Gold Coast Hospital District using MIS and SGA/PG-SGA. An annual malnutrition audit was conducted over a 2 month period with 100 in centre Haemodialysis patients across 2 centres. For each patient a nutritional assessment was conducted using SGA or PG-SGA and MIS assessment tool. The MIS tool was adapted to suit Australian laboratory measurements and units (Alb, TIBC); and the BMI scale adapted to be inline with current guideline recommendations. Overall the malnutrition rate using PG-SGA/SGA was 28% of patients classified as “malnourished” (26% scored B- moderate malnutrition and 2% scored C-severe malnutrition). According to MIS the rate of malnutrition was 94% (39%-mild malnutrition; 22% moderate malnutrition; 33% severe malnutrition). In conclusion there is discrepancy in the rate of malnutrition when assessed according to different tools. MIS has been shown to be a better predictor of survival in dialysis patients. We need interventional studies to assess the utility of MIS in improving patient outcome and survival in dialysis patients