Author(s): Tsai, AC (Tsai, Alan C.); Lu, SJ (Lu, Shu-Jen); Chang, TL (Chang, Tsui-Lan) Title: Modified Mininutritional Assessment Can Effectively Assess the Nutritional Status of Patients on Hemodialysis
Source: JOURNAL OF RENAL NUTRITION, 19 (5): 380-388 SEP 2009 Language: English
Document Type: Article
KeyWords Plus: SUBJECTIVE GLOBAL ASSESSMENT; CHRONIC KIDNEY-DISEASE;
STAGE RENAL-DISEASE; MAINTENANCE HEMODIALYSIS; ELDERLY TAIWANESE;
SERUM-ALBUMIN; POPULATION; FUNCTIONALITY; INFLAMMATION; RELIABILITY Abstract: Objective: We sought to determine whether the MNA (Mininutritional Assessment) would be an effective tool for assessing the nutritional status of patients undergoing
hemodialysis.
Design: Purposive sampling.
Setting: Two hospital-managed hemodialysis centers in central Taiwan.
Patients: Subjects were 95 ambulatory patients older than 40 years without acute diseases or infections who had received hemodialysis treatment at the center for longer than 30 days.
Methods: Each subject was interviewed with a structured questionnaire to elicit basic personal data and health- and lifestyle-related information and answered questions on the Council on Nutrition Appetite Questionnaire and MNA. Serum biochemical data were obtained from their routine measurement. The nutritional status of each subject was graded with two modified MNA versions. MNA-TI adopted population-specific anthropometric cut-points, and MNA-TII further had the body mass index question deleted from the scale and question scores adjusted but maintained the same 30 total points.
Results: Based on the strength of correlation with the key nutrition-related parameters including appetite status, serum creatinine, percent weight loss, hospital length of stay, number of prescribed drugs, and hemodialysis time, both modified MNA versions reflected the nutritional status of Taiwanese hemodialysis patients better than the Council on Nutrition Appetite Questionnaire. Serum albumin did not reflect nutritional status well in these
hemodialysis patients. MNA-TI predicted 26.4% and MNA-TII predicted 29.5% of hemodialysis patients were either malnourished or at risk of malnutrition.
Conclusions: Both versions of the modified MNA are effective in assessing the nutritional status of hemodialysis patients. MNA-TII without body mass index is a significant improvement for hemodialysis patients because body weights fluctuate significantly between dialysis sessions. (C) 2009 by the National Kidney Foundation, Inc. All rights reserved.
Addresses: [Tsai, Alan C.] Univ Michigan, Sch Publ Hlth, Human Nutr Program, Ann Arbor, MI 48109 USA; [Tsai, Alan C.; Lu, Shu-Jen; Chang, Tsui-Lan] Asia Univ, Grad Inst Long Term Care, Taichung, Taiwan
Reprint Address: Tsai, AC, Univ Michigan, Sch Publ Hlth, Human Nutr Program, Ann Arbor, MI 48109 USA.
E-mail Address: atsai@asia.edu.tw
Cited References: *NAT KIDN FDN, 2000, AM J KIDNEY DIS S, V34, S1.
*NESTL NUTR I, MNA MIN NUTR ASS MNA.
AFSAR B, 2006, J RENAL NUTR, V16, P277, DOI 10.1053/j.jrn.2006.01.012.
CHUMLEA WC, 2003, J RENAL NUTR, V13, P31, DOI 10.1053/jren.2003.50003.
COOPER BA, 2002, AM J KIDNEY DIS, V40, P126, DOI 10.1053/ajkd.2002.33921.
DWYER JT, 2005, KIDNEY INT, V68, P1766.
GUIGOZ Y, 1994, FACTS RES GERONTOL S, V2, P15.
GURREEBUN F, 2007, J RENAL NUTR, V17, P114.
IKIZLER TA, 1996, KIDNEY INT, V50, P343.
JONES CH, 2004, J RENAL NUTR, V14, P26, DOI 10.1053/j.jm.2003.09.006.
KAYSEN GA, 2004, KIDNEY INT, V65, P1408.
KUHLMANN MK, 2008, BLOOD PURIFICAT, V26, P49, DOI 10.1159/000110564.
LEE RD, 2003, ASSESSMENT HOSP PATI, P216.
LEGG V, 2005, AM J NURS, V105, P40.
MILLER DK, 1996, J AM GERIATR SOC, V44, P959.
SAVINA C, 2003, J NUTR HEALTH AGING, V7, P385.
STEIBER A, 2007, J RENAL NUTR, V17, P336, DOI 10.1053/j.jrn.2007.05.004.
STEIBER AL, 2004, J RENAL NUTR, V14, P191, DOI 10.1053/j.jm.2004.08.004.
THIJSSEN S, 2007, J RENAL NUTR, V17, P70, DOI 10.1053/j.jrn.2006.10.011.
THOMAS DR, 2000, J GERONTOL A-BIOL, V55, M725.
TSAI AC, 2006, J NUTR HLTH IN PRESS.
TSAI AC, 2008, BRIT J NUTR, V100, P152, DOI 10.1017/S0007114507873600.
TSAI AC, 2008, J CLIN NURS 0728.
TSAI AC, 2008, J NUTR HEALTH AGING, V12, P696.
TSAI ACH, 2007, ASIA PAC J CLIN NUTR, V16, P656.
VELLAS B, 2006, J NUTR HEALTH AGING, V10, P456.
WILSON MMG, 2005, AM J CLIN NUTR, V82, P1074.
YAMADA K, 2008, AM J CLIN NUTR, V87, P106.
Cited Reference Count: 28 Times Cited: 0
Publisher: W B SAUNDERS CO-ELSEVIER INC
Publisher Address: 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA
ISSN: 1051-2276
DOI: 10.1053/j.jrn.2008.11.010
29-char Source Abbrev.: J RENAL NUTR ISO Source Abbrev.: J. Renal Nutr.
Source Item Page Count: 9
Subject Category: Nutrition & Dietetics; Urology & Nephrology ISI Document Delivery No.: 529JC
