Improving Malnutrition Screening among Hemodialysis Patients

Author:

Sharma Parpia Arti12,Valenzano Teresa J.234,Bosma Rachael3,Bavota Brianna1,Deveaux Gabrielle1,Wald Ron12,Bradley Kimberley24

Affiliation:

1. St. Michael’s Hospital, Unity Health Toronto, Toronto, ON

2. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON

3. Interprofessional Practice Based Research, Unity Health Toronto, Toronto, ON

4. Health Disciplines Practice & Education, Unity Health Toronto, Toronto, ON

Abstract

Individuals receiving hemodialysis are at increased risk of malnutrition; however, regular diagnosis of malnutrition using subjective global assessment (SGA) is time-consuming. This study aimed to determine whether the Canadian Nutrition Screening Tool (CNST) or the Geriatric Nutrition Risk Index (GNRI) screening tools could accurately identify hemodialysis patients at risk for malnutrition. A retrospective medical chart review was conducted for in-centre day shift hemodialysis patients (n = 95) to obtain the results of the SGA assessment and the CNST screener and to calculate the GNRI score. Sensitivity and specificity analyses showed only a fair agreement between the SGA and CNST (sensitivity = 20%; specificity 96%; κ = .210 (95% CI, -0.015 to .435), p < .05) and between the SGA and GNRI (sensitivity = 35%; specificity = 88%; κ = .248 (95% CI, .017 to .479), p < .05). There was no significant statistical difference between the accuracy of either tool in identifying patients at risk of malnutrition (p = .50). The CNST and GNRI do not accurately screen for risk of malnutrition in the hemodialysis population; therefore, further studies are needed to determine an effective malnutrition screening tool in this population.

Publisher

Dietitians of Canada

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