Developing and Validating a Renal Nutrition Screening Tool to Effectively Identify Undernutrition Risk Among Renal Inpatients

Objective To develop and validate a nutrition screening tool that is effective to recognize renal inpatients at risk of undernutrition. Design A prospective, criterion validation. Subjects Adults admitted to a hospital ward with acute kidney injury, chronic kidney disease, and dialysis regardless of gender or ethnicity (n = 122) were recruited. Intervention The renal nutrition screening too (R-NST) was developed from the Malnutrition Screening Tool and renal specific risk variables such as biochemical measures to identify renal inpatients who are at undernutrition risk. Main Outcome Measure The undernutrition risk of each participant was independently assessed using the R-NST and the 7-point Subjective Global Assessment (SGA). The R-NST was autonomously used by nursing staff to determine its feasibility as a routine screening method at ward level. Results The SGA and R-NST tools classified 53.3% and 68.0% of participants as malnourished or at undernutrition risk, respectively. The R-NST was determined to be valid to detect undernutrition risk (sensitivity = 97.3%, specificity = 74.4%, positive predictive value = 88.0%, and negative predictive value = 93.6%) compared with the SGA. The R-NST also showed ability to recognize timely dietetic intervention required due to renal conditions. The compliance rate in the R-NST screening by the nursing staff was low (22.6%). Conclusion The R-NST is a good screening tool for identifying renal inpatients at undernutrition risk. Further research is warranted to explore innovative yet effective strategies to establish undernutrition screening as standard renal ward practice.