![]() | Only 14 pages are availabe for public view |
Abstract Although, protein calorie malnutrition is common in hemodialysis patients and is linked to increased morbidity and mortality, nutritional status is frequently ignored in many dialysis centers (Asgarani et al., 2004). The aim of this study was to elucidate the frequency and severity of malnutrition in dialysis patients and to determine the correlations among prealbumin and other nutritional parameters including biochemical markers, anthropometric measurements and subjective global assessment. This cross-sectional study assessed 50 HD patients with CRF from Ahmed Maher Teaching Hospital Dialysis Unit. The study comprised patients over the age of 18, on dialysis for more than 3 months, who could complete the SGA questionnaire and undergo the following measurements: body weight, height, skinfold thickness, and arm circumference. The following were excluded from the study: pregnant women, patients with limb amputation or paraplegia, patients that were hospitalized for more than 2 weeks for non-vascular access complications, or with signs of active infection. The population studied underwent nutritional assessment by use of a complete medical history and examination, clinical indicators, anthropometric measurements and biochemical indicators. In this study the prevalence of malnutrition varied a lot (from 6%-76%), depending on the method used for diagnosis. In our study there was a significant direct correlation between serum prealbumin and serum cholesterol levels, serum creatinine, serum albumin and serum transferrin, while serum albumin showed a significant direct correlation with serum cholesterol and serum creatinine. Both serum albumin and pre albumin showed no significant correlation with serum BUN, nPCR, Kt/v and no correlation with SGA scores or anthropometric measurements. This means that serum albumin and prealbumin both reflect similar nutritional status with serum prealbumin being more sensitive to changes in serum transferrin levels. This may be due to the shorter half life of prealbumin (2 days) and transferrin (8.5 days) compared to serum albumin (20 days). In this study there was a significant positive correlation of SGA with anthropometric measurements (TSF, MAC and MAMC) and no correlation with other biochemical parameters. This may be due to that anthropometric changes are late to manifest and recover in compare with biochemical parameters specially with short half lives eg., serum prealbumin and transferrin making it unuseful for early detection of malnutrition and follow up improvements with nutritional intervensions. Also the fact that SGA is not an objective method (subjective) depending on the medical stuff performing the assessment. In conclusion we found malnutrition highly prevelant with a wide range (6%-76%) in hemodialysis patient. Prealbumin was correlated to other nutritional markers (serum albumin, transferrin and creatinine) being more sensitive to early nutritional changes than commonly used parameters such as serum albumin. SGA is a simple, cheap and reproducible method for nutritional assessment but it does not reflect early nutritional changes and so not useful in earlydetection of malnutrition or monitoring response to nutritional interventions. |