- 期刊
- OpenAccess
Seven-Point Subjective Global Assessment Correlates With Nutritional Status and Muscle Strength in Maintenance Hemodialysis Patients
摘要
BACKGROUND: Malnutrition is one of the major risk factors for morbidity and mortality in patients undergoing maintenance hemodialysis (MHD). The use of the 7-point Subjective Global Assessment (SGA) is recommended as a valid and reliable tool for assessing nutritional status in adults with chronic kidney disease 5D. This study aimed to assess the clinical application of 7-point SGA and the correlation among 7-point SGA, the objective nutritional parameters, and muscle strength in MHD patients. METHODS: This study enrolled 110 uremic patients (male: n = 49, female: n = 61) aged 20 and above (mean 62 ± 12) who underwent MHD. A well-trained renal dietitian performed the 7-point SGA, and the nutritional status was determined by measuring the biochemical parameters, anthropometrics such as the triceps skinfold, mid-arm circumference (MAC), and mid-arm muscle circumference (MAMC), and muscle strength by the handgrip strength (HGS). RESULTS: A total of 110 patients (49 men, 61 women; mean age 62 ± 12 years) were included in the final analysis. There was a higher prevalence of male gender (57% vs. 26%, P = 0.0013) and a lower prevalence of heart failure (28% vs. 49%, P = 0.0419), and stroke (5% vs. 16%, P = 0.0459) in the well-nourished group. The well-nourished patients had higher serum albumin and sodium levels (4.3 ± 0.3 vs. 4.1 ± 0.4 g/ dL, P = 0.0036; 139 ± 3 vs. 137 ± 3 mEq/L, P = 0.0004, respectively), and higher HGS (26.2 ± 9.2 vs.17.5 ± 7.5 kg, P ＜ 0.0001) than patients in the malnourished group. MAC (25.3 ± 4.1 vs. 27.4 ± 3.9 cm, P = 0.0117), MAMC (19.5 ± 3.1 vs. 21.6 ± 3.5 cm, P = 0.0028) and MAMA (31.1 ± 9.5 vs. 37.9 ± 12.3 cm^2, P = 0.0031) were lower in the malnourished group. Multiple logistic regression analysis (model 2) showed that male gender (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.04-0.82), serum sodium (OR, 0.75; 95% CI, 0.61-0.92), MAC (OR, 0.81; 95% CI, 0.67-0.98) and HGS (OR, 0.91; 95% CI, 0.83-0.99) had statistically significant inverse association with malnutrition, and heart failure (OR, 3.13; 95% CI, 1.01-9.69), and stroke (OR, 6.97; 95% CI, 1.08-44.95) had significant association with malnutrition. CONCLUSION: Nutritional status in MHD patients based on 7-point SGA correlated with gender, comorbidities, clinical nutritional and anthropometric parameters, and muscle strength. The 7-point SGA could be an alternative tool for the assessment of nutritional status in MHD patients.