Evaluación global subjetiva y escala de malnutrición-inflamación para valorar el estado nutricional de pacientes en diálisis peritoneal con hipoalbuminemia

Abstract

Patients with chronic renal deficiency on peritoneal dialysis are often poorly nourished or at risk of malnutrition due to their special characteristics, and this is exacerbated by a range of factors, including other associated pathologies, unsuitable dialysis, inflammatory state, loss of nutrients due to the dialysate, etc.
Numerous methods for assessing nutritional status have been described, among which anthropometric measurements and laboratory determinations are the most widely-used. However, when these are applied to renal patients the results obtained are highly variable, and moreover problems arise with putting some of them into practice, due to the special features of dialysis patients.
One way of preventing malnutrition is to identify the patients at risk and avoid their gradual deterioration. The aim here is to assess the nutritional status of patients on peritoneal dialysis with hypoalbuminaemia. We selected 21 patients with over 3 months on peritoneal dialysis and with a tendency to suffer hypoalbuminaemia < 3.6g/dl. We appraised their nutritional status using the subjective overall assessment scale and the malnutrition-inflammation scale.
We found that most patients had a low estimated risk of malnutrition according to both the subjective global assessment where 85.7% had a low risk of malnutrition or a normal nutritional status and the malnutrition-inflammation scale, which likewise gave 85% with a normal nutritional status. We must therefore use a combination of different methods to properly assess nutritional status and identify those at risk of malnutrition.