Concordância entre Semiologia Nutricional Sistematizada e métodos de avaliação nutricional - Malnutrition Inflammation Score e Avaliação Subjetiva Global - em pacientes renais crônicos em hemodiálise

Abstract

Introduction: Chronic Kidney Disease is a rising public health issue, and malnutrition is a common problem, mainly among patients on hemodialysis. Recent nutritional assessment tools have been suggested in order to avoid the interference of fluid accumulation in this kind of assessment, one of them is the Nutrition-Focused Physical Examination (NFPE), which is based on a detailed physical examination, besides being an innovative, practical and low-cost tool. The aim of the present study is to evaluate the agreement between NFPE and Subjective Global Assessment and Malnutrition Inflammation Score. Methods: A cross-sectional study, performed in a hemodialysis unit located in the Hospital Universitário Professor Edgard Santos, situated in Salvador- Bahia. Socioeconomic and anthropometric data were collected through a semi-structured questionnaire, and clinical data were obtained from physical patient records. Nutrition-Focused Physical Examination, Subjective Global Assessment and Malnutrition Inflammation Score questionnaires were applied. The Kappa statistics was used to evaluate the agreement between the methods of nutritional assessment Results: 60 individuals were evaluated, the average age was 57 years (±14,39). From this sample, 53,3% were female and 55% were adults. Comorbidities Systemic Arterial Hypertension and Diabetes mellitus had a higher frequency, respectively 95% and 48,3%. SGA and MIS found a malnutrition frequency of 64,4 % and 62,7%, respectively. NFPE identified a 35% frequency of malnutrition. According to Kappa statistic NFPE and SGA had a moderate agreement (K=0.405, p<0.001); and NFPE and MIS had a fair agreement (K=0.242, p=0,031). Agreement between NFPE and SGA was higher than between NFPE and MIS. Conclusion: NFPE seems to be a good alternative to assess nutritional status in Chronic Kidney Disease patients on hemodialysis. Combination between methods is still the best option to assess nutritional status in this public.