Original scientific paper
https://doi.org/10.31895/hcptbn.16.1-2.7
Combining hand grip strength with nutritional screening tools in elderly patients with chronic kidney disease
Anja Vukomanović
Ivica Vrdoljak
Ines Panjkota Krbavčić
Tea Vrdoljak Margeta
Martina Bituh
Abstract
Malnutrition in vulnerable patient populations must be rapidly detected using techniques that are easy to incorporate into everyday clinical practice.
The new recommendations defined the 7-point Subjective Global Assessment (SGA) as optimal for nutritional assessment in chronic kidney disease
(CKD), while Geriatric Nutrition Risk Index (GNRI) demands additional examination in elderly. This study aimed to determine the accuracy of
several concise tools used in the clinical practice and the correlation of this tools with functional method hand grip strength (HGS) in elderly patients
with CKD. In this cross-sectional study, anthropometric and functional data for 50 elderly hemodialysis patients were analyzed using numerous
survey-based tools for screening nutritional status (Malnutrition Screening Tool – MST, Nutritional Risk Screening 2002 - NRS2002, Malnutrition
Universal Screening Tool - MUST, Mini Nutritional Assessment - MNA, GNRI), which we compared to the standard 7-point SGA nutritional
assessment tool. The sensitivity, specificity, and accuracy of these tools for detecting malnutrition were compared with the standard by using receiver
operating characteristic (ROC) curve analysis. 7-point SGA classified 36.6% of participants as well nourished, and 63.4% as mildly to moderately
malnourished, while the simplest alternative methods showed lower accuracy, classifying much higher proportions of participants as well nourished
(MST, 92.0%; NRS2002, 80.4%). MNA had the highest accuracy based on receiver operating characteristic curves. HGS correlated moderately with
7-point SGA (r = 0.331), MNA (r = 0.410), and GNRI (r = 0.320). Our small study suggests that MNA is the best tool for malnutrition risk screening
in elderly with CKD. Combining HGS with concise tools, such as GNRI, may provide better results and unburden healthcare professionals.
Keywords
chronic kidney disease; hemodialysis; malnutrition; nutritional status; screening
Hrčak ID:
265098
URI
Publication date:
1.6.2021.
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