Assessment of Nutritional Status of Nepalese Hemodialysis Patients by Anthropometric Examinations and Modified Quantitative Subjective Global Assessment.
OBJECTIVE
To assess the nutritional status of patients on maintenance hemodialysis by using modified quantitative subjective global assessment (MQSGA) and anthropometric measurements.


METHODS
We Conducted a cross sectional descriptive analytical study to assess the nutritional status of fifty four patients with chronic kidney disease undergoing maintenance hemodialysis by using MQSGA and different anthropometric and laboratory measurements like body mass index (BMI), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), triceps skin fold (TSF) and biceps skin fold (BSF), serum albumin, C-reactive protein (CRP) and lipid profile in a government tertiary hospital at Kathmandu, Nepal.


RESULTS
Based on MQSGA criteria, 66.7% of the patients suffered from mild to moderate malnutrition and 33.3% were well nourished. None of the patients were severely malnourished. CRP was positive in 56.3% patients. Serum albumin, MAC and BMI were (mean + SD) 4.0 + 0.3 mg/dl, 22 + 2.6 cm and 19.6 ± 3.2 kg/m(2) respectively. MQSGA showed negative correlation with MAC (r = -0.563; P = <0.001), BMI (r = -0.448; P = <0.001), MAMC (r = -0.506; P = <.0001), TSF (r = -0.483; P = <.0002), and BSF (r = -0.508; P = <0.0001). Negative correlation of MQSGA was also found with total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol without any statistical significance.


CONCLUSIONS
Mild to moderate malnutrition was found to be present in two thirds of the patients undergoing hemodialysis. Anthropometric measurements like BMI, MAC, MAMC, BSF and TSF were negatively correlated with MQSGA. Anthropometric and laboratory assessment tools could be used for nutritional assessment as they are relatively easier, cheaper and practical markers of nutritional status.
Department of Nephrology, National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu, Nepal.
Arun
A
Sedhain
Department of Nephrology, National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu, Nepal.
Rajani
R
Hada
Department of Nephrology, National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu, Nepal.
Rajendra Kumar
RK
Agrawal
Advanced Analytics, Optumlnsight, Rocky Hill, CT, USA. Study location: Department of Nephrology, National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu, Nepal.
Gandhi R
GR
Bhattarai
Department of Nephrology, National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu, Nepal.
Anil
A
Baral
CKD; MQSGA; anthropometric measuremen; hemodialysis; nutritional status