title: Concurrent and Predictive Validity of Composite Methods to Assess Nutritional Status in Older Adults on Hemodialysis.
abstract: OBJECTIVE
  To assess the performance of subjective global assessment (SGA), malnutrition inflammation score (MIS), and mini nutritional assessment short-form (MNA-SF) in older adults on hemodialysis (HD) by evaluating their concurrent and predictive validity.
  
  
  METHODS
  An observational and prospective study including older adults on HD.
  
  
  METHODS
  Six dialysis units.
  
  
  METHODS
  We assessed 137 HD patients aged ≥60 years (71.7% male, 70.2 ± 7.2 years).
  
  
  METHODS
  The nutritional status was assessed by 7-point SGA, MIS and MNA-SF, and by objective methods. Patients were followed up for 14.5 (8; 26.3) months (median and interquartile) to assess survival.
  
  
  RESULTS
  Protein energy wasting (PEW) was present in 63% of the patients when assessed by SGA, in 77% by MIS, and in 26% by MNA-SF. Most objective parameters of patients classified with PEW were lower (P < .05) than those from patients classified as well-nourished by SGA, MIS, and MNA-SF. In addition, the hazard of death was higher for patients classified as PEW by SGA (hazard ratio 2.63 [95% confidence interval 1.14-6.00]), MIS (5.13 [1.19-13.7]), and MNA-SF (2.53 [1.34-4.77]) in comparison to well-nourished patients.
  
  
  CONCLUSIONS
  The prevalence of PEW varied depending on the tool applied. SGA, MIS, and MNA-SF had good concurrent and predictive validity for the assessment of nutritional status, but SGA and MIS were likely to perform better than MNA-SF.
authors: Graduate Program in Food, Nutrition and Health, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors: Fernanda Galvão de Oliveira
authors: FG
authors: Santin
authors: Graduate Program in Food, Nutrition and Health, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors: Fernanda Guedes
authors: FG
authors: Bigogno
authors: Graduate Program in Food, Nutrition and Health, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors: Juliana Cordeiro
authors: JC
authors: Dias Rodrigues
authors: Division of Nephrology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors: Lilian
authors: L
authors: Cuppari
authors: Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: carla.avesani@gmail.com.
authors: Carla Maria
authors: CM
authors: Avesani
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000175:diagnosis* / Q000453:epidemiology*; D006435:Renal Dialysis; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D012709:Serum Albumin