The study compared the functionality of the original and the modified Mini Nutritional Assessment (MNA) for assessing the nutritional status of ambulatory hemodialysis (HD) patients in Taiwan. Using a structured questionnaire, the study elicited personal data, health-related information and answers to questions in the MNA with a structured questionnaire in 95 HD patients in two dialysis centers in southern Taiwan. Results showed that all three versions of the MNA could effectively assess the nutritional status of HD patients.
The total MNA scores were positively correlated (P<0.05) with serum albumin, predialysis creatinine, dialysis time/session, appetite status, mid-arm circumference and calf-circumference, and negatively correlated (P<0.05) with the number of chronic diseases, number of prescribed medicine and length of hospital stay during the past six months. However, based on the strength of the correlations with nutritional indicators, the MNA-TII, the version without BMI, had the best functionality. Furthermore, the correlations with the MNA scores are all stronger than with serum albumin, suggesting that the MNA can better reflect nutritional status of these patients than albumin. The MNA-TII predicted 2.1% of HD patients malnourished, 27.4% at risk of malnutrition, and 70.5% normal. These results suggest that the MNA, especially the MNA-TII, might be a useful tool for routine assessment of nutritional status in HD patients.
Since pinpointing true body weight is relatively difficult in HD patients, the MNA-TII has significant
advantage over other tools by not involving BMI. Depressed appetite and inadequate protein and energy intakes are common among HD patients. Periodic assessment will enable timely intervention to avoid full- bloom malnutrition. It can also improve the quality of life of the HD patients and possibly also save on the healthcare cost.
