Background: Subjective Global Assessment (SGA) is a nutritional assessment most frequently used for assessing the nutritional risk among patients with hemodialysis (HD) and peritoneal dialysis (PD).
However, special background and training is needed in order to use the tool properly. The Mini Nutritional Assessment (MNA) is a commonly used nutritional assessment tool. It is simple, non-invasive, and maybe accurately used by individuals without special training. However, feasibility of using the MNA in assessing PD patients has not been adequately assessed.
Objective: This study attempted to evaluate the possibility of using the MNA to predict the nutritional risk status of PD patients.
Methods: The study employed purposive sampling and recruited PD patients from a hospital-managed PD center in Central Taiwan. Subjects who agreed to participate and signed an informed consent were
interviewed with a structure questionnaire for eliciting basic personal data and answers to the MNA.
Subject’s nutritional status was assessed with the SGA and the MNA in two forms, the short form and the long form, for screening and assessment of nutritional status, respectively. The short form was composed of the first 6 questions of the 18 long form questions. The short and long form each has three versions: the original and two modified versions (T-1 and T-2). T-1 adopted population-specific anthropometric cut-points whereas T-2 further changed the weightings or the three anthropometric parameters in the scale and BMI was totally replaced by mid-arm circumference and calf circumference in the scale. All versions maintained the same total scores and rating scales as the original version. Results were analyzed with Spearman correlation and regression analysis.
Results: MNA short form T-1 and T-2 versions, like the SGA, rated fewer PD patients at risk of malnutrition than did the long form MNA. Results rated with the long form MNA correlated better with health or
nutritional indicators than did results predicted with the short form MNA or the SGA. Regression analysis suggests that age, Kt/V, serum albumin, appetite status, nPCR and calf circumference were associated with the nutritional status of PD patients.
Conclusion: Among the versions and scales examined, the long form MNA-T-2 appears to have the best predictive ability in rating the nutritional status of PD patients. The SGA and the short form MNA appear to under-rate the nutritional risk of PD patients. Some items that are included in the long form MNA but not in the short form MNA or the SGA appear to be the reason for the discrepancy.
