A WU1, C GODBER1, A CLOSE1,2, M GALLAGHER1,3, S SEN1,3
1University Of Sydney, Sydney, Australia, 2Canterbury Hospital , Sydney, Australia, 3Concord Repatriation General Hospital, Sydney, Australia
Background: Malnutrition in haemodialysis patients is associated with poorer outcomes such as increased mortality. However, current nutritional assessment tools such as the Subjective Global Assessment (SGA) are user-dependent and time-consuming. There is a need for a quantitative nutritional screening tool that is easily reproducible and predictive.
Aim: This ethics-approved, retrospective cohort study investigated correlations between past quantitative markers and current nutritional status to help with future prediction of nutritional state.
Methods: SGA scores were completed for haemodialysis patients (n = 86) at Concord Repatriation General Hospital in 2014-2015 as part of standard practice. Monthly routine blood tests from 2013-2015 were included for analysis. A literature search identified the following variables as likely to show correlation with nutritional status: albumin, creatinine, transferrin, phosphate, cholesterol, C-Reactive Protein (CRP), body mass index (BMI) and gender. An ordinal logistic regression was run with SPSS for variables 9, 6 and 3 months prior to the SGA assessment to determine the association of the included variables with the future SGA scores.
Results: At 3 and 6 months prior, BMI and creatinine significantly predicted SGA scores (p<0.05). At 9 months prior, only BMI significantly predicted SGA scores (p<0.05). Albumin approached significance at 6 and 9 months prior (p=0.065 and 0.063 respectively). Transferrin, cholesterol and CRP were excluded from analysis due to insufficient data points.
Conclusion: This study was limited by a small sample size and inconsistent data collection. However, it was still able to show the association of low BMI and low creatinine levels with malnutrition up to 9 months and 6 months prior to the SGA respectively. These findings demonstrate the importance of measuring these markers consistently in chronic dialysis patients.
Alex is a medical student at the University of Sydney and originally from Vancouver, Canada. He completed a Bachelor’s degree in Cell Biology and Economics at McGill University before coming to Australia to study Medicine.