Poster Topical Area: Medical Nutrition
Location: Hall D
Poster Board Number: 651
Objective: Malnutrition is associated with negative outcomes for adults on maintenance hemodialysis (MHD). Subjective Global Assessment (SGA) is commonly used for the nutritional assessment of those on MHD, though a gold standard for malnutrition identification in this population has not been identified. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and the Academy of Nutrition and Dietetics (Academy) have proposed a malnutrition diagnostic framework; however, there is no published research on its use with patients on MHD. The aim of this study was to determine the level of agreement between the SGA and the A.S.P.E.N./Academy framework (AAF) in identifying malnutrition among adults on MHD.
Methods: This study was a secondary analysis of an existing dataset from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Development and Validation of a Predictive Energy Equation in Hemodialysis study. Participants were evaluated retrospectively using surrogate markers for the AAF. SGA scores were compared to the framework results for all participants to determine the level of agreement in malnutrition identification. Participants were adults (N = 80) on MHD who participated in the Newark, NJ arm of the NIDDK study.
Results: The majority of the study participants were Black/African American (n = 65, 81.3%), non-Hispanic (n = 62, 77.5%), and were predominantly male (n = 44, 55.0%). The mean age of the study participants was 56.9 ± 9.9 years. Malnutrition prevalence identified by the AAF was 25% (n = 20), compared to 78.8% (n = 63) identified by the SGA. A κ of 0.131 indicated slight agreement between the AAF and the SGA. The most commonly reported malnutrition framework characteristic was reduced functional capacity (n = 41, 51.3%), while the "disease state/comorbidities" category had the highest number of scores within the malnutrition range (scores of 1-5) on the SGA (n = 75, 93.8%).
Conclusions: There was a difference in malnutrition prevalence identified by the two tools. Future prospective trials comparing the AAF to the SGA, as well as to clinical outcomes, will provide more data regarding how the framework identifies malnutrition.
Farmington Hills, Michigan