Modified Mis Sheet Is Desirable For The Nst Activity On Chronic Dialysis Patients

Nutritional status is the most important factor which guarantees long survival with higher quality of life on chronic dialysis patients. Various procedures for evaluating nutritional status have been proposed but the standard of them has not been established. We modified the MIS sheet, which was originally established by Kalantar-Zadeh, by adding some parameters as CRP, nPCR and the dialysis prescription on the same sheet. We have performed NST activity using the modified MIS sheet twice a year for recent 6 years. We categorize the patients into the next three groups based on total point of MIS; Normal, Mild malnourished and moderately/severely malnourished. The patient survival in each group could be clearly identified from each other. The causes of malnutrition were categorized as inflammatory type, mal-dietary type and mixed type. Therapeutic interventions were inducted for each type; those were a treatment for pyorrhea, foot care and a dialysis prescription change. Dietitians interviewed the patients with mal-dietary type malnutrition and their families. Every six months, we repeatedly evaluated the nutritional status of the patients and determined whether our interventions had succeeded. Our modified MIS sheet is not only a screening tool but a practical tool by which we can make a therapeutic plan for various types of malnutrition. Our preliminary results clarified that the interventions derived from the MIS system could significantly improve the total score of MIS. In conclusion the modified MIS sheet is desirable for a daily NST activity on chronic dialysis patients.