Comparison between direct and indirect methods to diagnose malnutrition and cardiometabolic risk in haemodialisys patients.
The present study aimed to evaluate the nutritional status of patients undergoing haemodialysis (HD) by comparing nutritional risk scores with biochemical, anthropometric and body composition variables.



Eighty-five individuals [65.9% male, mean (SD) age 62 (14) years] participated in a cross-sectional study. Global Objective Assessment (GOA) and Modified Global Subjective Assessment (mGSA) scores, as well as biochemical, anthropometric and body composition data, were collected using standardised procedures.



The prevalence of malnutrition ranged from 20.0% (% body fat by electrical bioimpedance) to 95.3% (by GOA), depending on the indicator or score used. According to the waist circumference, 61.2% of the individuals presented abdominal obesity and visceral adipose tissue was excessive in 20% of them. Malnutrition diagnosis by GOA showed the relationship between the anthropometric and body composition indicators, as assessed by the extent that the ratings of risk nutritional/mild malnutrition and mainly moderate malnutrition were accompanied by a significant decrease in nutritional status and body composition variables. However, with respect to categories of mGSA, no statistically significant differences were observed for nutritional status and body composition variables. In the receiver operator characteristic curve analyses, mGSA and GOA were good indicators for diagnosing malnutrition because both achieved an AUC > 0.5.



mGSA and GOA were more sensitive with respect to identifying individuals at nutritional risk compared to the isolated anthropometric indicators, thus indicating their utility in diagnostic malnutrition. However, individuals at high nutritional risk also presented cardiometabolic risk, as diagnosed mainly by central fat indicators, suggesting the application of both malnutrition and cardiometabolic risk markers in HD patients.
Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
K P
KP
Balbino
Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
A P S
APS
Epifânio
Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
S M R
SMR
Ribeiro
Division of Nephrology, São João Batista Hospital, Viçosa, Brazil.
L D M
LDM
da Silva
Division of Nephrology, São João Batista Hospital, Viçosa, Brazil.
M G
MG
Gouvea
Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
H H M
HHM
Hermsdorff
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D055815:Young Adult
ROC curve; cardiometabolic risk; chronic kidney disease; malnutrition; modified global subjective assessment; objective global assessment