Difficulties in screening for protein-calorie deficiency in patients on program hemodialysis

Introduction. Development of a highly sensitive and specific methodology of screening for protein-calorie deficiency (PCD) in patients on program hemodialysis (HD). Material and methods. a total of 645 patients on program HD were examined, including 300 men and 345 women aged 56.8±і2.8 years. All patients received treatment with program HD for 8.4±5.3 years. The assessment of nutritional status for the diagnosis of PCD was carried out using the method of the Ministry of Health of the Russian Federation (MHRF) and the method proposed by the International Society of Renal Nutrition and Metabolism (ISRNM). For the screening for PCD, Malnutrition Universal Screening Tool (Must), Nutritional Risk Screening (NRS), Nottingham screening tool (NST), Malnutrition Screening Tool (MST), Malnutrition-Inflammation Score (mis) were used. Results. When the PCD was diagnosed using the MHRF methodology, screening methods must, NRS, NST, MST, has demonstrated the PCD diagnostic accuracy index not exceeding 36%; the PCD diagnostic accuracy index using mis method was 53%. When the PCD was diagnosed using ISRNM methodology, all screening methods showed an accuracy index of the PCD diagnosis in the range of 53-6і%. In the diagnosis of the PCD by the MHRF methodology, the MEGASCRIN screening technique showed a sensitivity of 92% with 72.5% specificity, overall accuracy index of 0.76. At the same time, in the diagnosis of the PCD by the ISRNM methodology, the MEGASCRINE screening method demonstrated 7і% sensitivity with 92.5% specificity, an overall accuracy index of 0.8і. Conclusion. The MEGASCRINE method of screening for BCD in HD patients has demonstrated acceptable predictive value and could be recommended for routine use in screening for PCD in HD patients regardless of the method of PCD diagnosis in the future.

hemodialysis, protein-calorie deficiency, screening