title: Role of nutrition impact symptoms in predicting nutritional status and clinical outcome in hemodialysis patients: a potential screening tool.
abstract: OBJECTIVE
  This study aims to establish the utility of the Nutrition Impact Symptoms (NIS), a part of the Patient-Generated Subjective Global Assessment (PG-SGA) as a nutritional screening tool in patients receiving hemodialysis (HD).
  
  
  METHODS
  This was a prospective observational study.
  
  
  METHODS
  The study took place in a single public tertiary in-center dialysis facility in Australia.
  
  
  METHODS
  Patients included 213 individuals receiving maintenance HD for at least 3 months who were older than 18 years of age (mean age, 58.9 ± 16.3 years; 55.4% [n = 118] male patients).
  
  
  METHODS
  Malnutrition, which was classified by the Subjective Global Assessment rating (SGA, B or C) and the nutrition-related clinical outcome (decline in weight [>5%], SGA, reduction in serum albumin [>5 g/L]), or 12-month mortality.
  
  
  RESULTS
  Patients assessed as malnourished totaled 23.5% (n = 50). Total PG-SGA and NIS scores showed a comparable ability to predict malnutrition (area under the curve, 0.93 [95% confidence interval {CI}, 0.90-0.97] and 0.86 [95% CI, 0.80-0.93], respectively). NIS (score ≥2) was independently related to poor nutrition-related clinical outcome (odds ratio [OR], 3.03; 95% CI, 1.47-6.20) and mortality (OR, 1.11; 95% CI, 1.03-1.20) adjusted for age, dialysis vintage, serum albumin level, and comorbidities.
  
  
  CONCLUSIONS
  NIS score is a promising nutritional screening tool for the identification of patients receiving hemodialysis who are at risk of malnutrition and poor clinical outcome. Further research is required to investigate the reliability and utility of this tool in a larger population group.
authors.affiliation: Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia. Katrina_Campbell@health.qld.gov.au
authors.forename: Katrina L
authors.initials: KL
authors.lastname: Campbell
authors.forename: Judith D
authors.initials: JD
authors.lastname: Bauer
authors.forename: Aya
authors.initials: A
authors.lastname: Ikehiro
authors.forename: David W
authors.initials: DW
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology*; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D015203:Reproducibility of Results; D012307:Risk Factors; D012709:Serum Albumin
chemical_list: D012709:Serum Albumin