New opportunities for screening protein-energy wasting of haemodialysis patients

Abstract

The aim of the study. To compare the effectiveness of screening techniques for protein-energy wasting (PEW) in haemodialysis patients (HD). Patients and methods. A total of 645 haemodialysis patients were examined (300 men, 345 women age 56.8±12.8 years. All patients received treatment HD for 8.4±5.3 years. The assessment of nutritional status in order to diagnose PEW was carried out using the method of the Russian Ministry of Health (RMH) and the method proposed by the International Society of Renal Nutrition and Metabolism (ISRNM). Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening (NRS), Nottingham screening tool (NST), Malnutrition Screening Tool (MST), Malnutrition-Inflammation Score (MIS) were used for screening PEW. Results. When diagnosing PEW by RMH method of screening MUST, NRS, NST, MST showed an index of diagnosis of PEW, not exceeding 36%, the index of accuracy of diagnosis of PEW using MIS was 53%. When diagnosing PEW by the ISRNM method, all screening methods showed an index of accuracy of the diagnosis of PEW in the range of 53-61%. In the diagnosis of PEW by the MR method, the screening technique of the PEW "MEGASCRIN" demonstrated a sensitivity of 92% with a specificity of 72.5%, the overall accuracy index was 76%. At the same time, when diagnosing PEW using the ISRNM method, the "MEGASCRIN" PEW screening method demonstrated a sensitivity of 71% with a specificity of 92.5%, an overall accuracy index of 81%. Conclusion. The screening technique of the "MEGASCRIN" PEW in haemodialysis patients demonstrated acceptable predictive value and can be recommended for routine use when screening PEW in haemodialysis patients, regardless of the method for diagnosing PEW in the future.