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Part 3: Clinical Experiences |
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; and Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, PR China
Correspondence to: J. Dong, Renal Division, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing 100034 PR China. dongjie{at}medmail.com.cn
Objective: We investigated whether patients with
gastrointestinal (GI) symptoms were prone to be diagnosed as malnourished by
subjective global assessment (SGA) by simultaneously evaluating SGA and other
indices of nutrition in a cross-sectional survey of peritoneal dialysis (PD)
patients.
Patients and Method: From June 2006 to June 2007, 214
PD patients were involved in the study. We recorded results of a GI symptoms
questionnaire (GSQ) and SGA. Other indices of nutrition included dietary
intake, chemistry examination, anthropometry, handgrip strength, and lean body
mass measured by creatinine kinetics.
Results: Mean age of the 214 PD patients enrolled in
the study was 60.22 ± 14.02 years, and mean dialysis duration was 60.22
± 14.02 months. Of the 214 patients, 56 (27.16%) were diagnosed as
malnourished by SGA. The mean GSQ scores were 9.37 ± 1.71 (range: 8
– 17). There were 90 patients with GSQ scores of 8 (group 1), 80
patients with scores of 9 or 10 (group 2), 44 patients with scores of 11 or
more (group 3). The prevalence of malnutrition diagnosed by SGA was
significantly different in the three groups: 15.56% in group 1, 27.5% in group
2, and 45.45% in group 3 (p = 0.02). However, we observed no
difference between the three groups in mid-arm circumference, skinfold
thickness (biceps, triceps, subscapular, and suprailiac), daily protein and
energy intake, handgrip strength, lean body mass, and serum albumin and
prealbumin levels (p > 0.05).
Conclusions: Our results showed that the reliability of
SGA in PD patients with GI symptoms remains worth exploring. These patients
are possibly diagnosed as malnourished by SGA, although many other indices of
nutrition are not necessarily bad.
KEY WORDS: Nutrition; subjective global assessment; gastrointestinal symptoms.
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