Prediyaliz Kronik Böbrek Hastalığında Malnütrisyon Prevalansının ve Malnütrisyon İnflamasyon Skorunun Değerlendirilmesi

Abstract

Amaç: Kronik böbrek hastalığı (KBH) olan bireylerin beslenme durumlarını değerlendirmede bileşik beslenme indekslerinin kullanılması önerilmektedir. Bu çalışmanın amacı, diyaliz tedavisi almayan KBH’li bireylerde Malnütrisyon İnflamasyon Skoru (MİS) düzeyinin belirlenerek KBH evresine ve MİS’e göre bireylerin antropometrik ölçümlerinin, biyokimyasal parametrelerinin ve beslenme durumlarının değerlendirilmesidir. Gereç ve Yöntem: Çalışma, prediyaliz 118 KBH’li birey ile yürütülmüştür. Bireylerin beslenme durumları Subjektif Global Değerlendirme (SGD) ve MİS ile belirlenmiştir. MİS’in artmasıyla malnütrisyon şiddetinin arttığı kabul edilmiştir. Bulgular: Bireylerin SGD’ye göre %20,3’ünde orta/ciddi düzeyde malnütrisyon görüldüğü ve KBH evresi arttıkça MİS’in anlamlı düzeyde arttığı belirlenmiştir. Bireylerin KBH evrelerine göre yağsız vücut kütlesi, kan glukozu, albümin, üre, kreatinin, ferritin, kalsiyum, fosfor düzeylerinin; protein, toplam yağ, tekli-doymamış yağ asidi, omega-3 yağ asidi, kolesterol, riboflavin, B12 vitamini, kalsiyum, fosfor ve çinko alım miktarlarının farklılık gösterdiği saptanmıştır (p<0,05). Bireylerin MİS değeri; üst orta kol çevresi, vücut yağ yüzdesi (VYY), kalsiyum ve üre düzeyleri ile anlamlı ilişkiye sahiptir (p<0,05) ve MİS’i en fazla VYY (%4,2) ve serum kalsiyum (%7,3) düzeyleri açıklamaktadır. Sonuç: MİS; KBH evresi, antropometrik ölçümler ve biyokimyasal parametreler ile ilişkilidir. Bu nedenle belirli aralıklarla MİS’in kullanılması, KBH’de malnütrisyon prevalansının ve hastalık maliyetinin azalmasında, hastaların yaşam kalitesinin artmasında etkili olacaktır.

Keywords

• antropometrik ölçümler
• beslenme
• biyokimyasal parametreler
• kronik böbrek hastalığı
• malnütrisyon inflamasyon skoru

Assessment of Malnutrition Prevalence and Malnutrition Inflammation Score in Predialisis Chronic Kidney Disease

Abstract

Objectives: It is recommended to use combined nutritional indices to evaluate the nutritional status of individuals with chronic kidney disease (CKD). The aim of this study was to determine the Malnutrition Inflammation Score (MIS) level in individuals with CKD who were not receiving dialysis treatment and to evaluate the anthropometric measurements, biochemical parameters, and nutritional status of individuals according to CKD stage and MIS. Materials and Methods: The study was conducted with 118 predialysis individuals with CKD. Nutritional status of individuals was determined by Subjective Global Assessment (SGA) and MIS. It was accepted that the severity of malnutrition increased as the MIS score increased. Results: It was defined that 20.3% of individuals had moderate/severe malnutrition according to SGA, and as the CKD stage increased, the MIS increased significantly. It had been determined that individuals' lean body mass, blood glucose, albumin, urea, creatinine, ferritin, calcium, and phosphorus; intake of protein, total fat, monounsaturated fatty acid, omega-3 fatty acid, cholesterol, riboflavin, vitamin B12, calcium, phosphorus, and zinc vary depending on their CKD stage (p<0,05). Individuals' MIS value had a significant correlation with upper middle arm circumference, body fat percentage (BFP), calcium, and urea levels. The BFP (4.2%) and serum calcium (7.3%) levels mostly explain the MIS. Conclusion: MIS is associated with CKD stage, anthropometric measurements, and biochemical parameters. Therefore, using MIS at regular intervals will be effective in reducing the prevalence of malnutrition and the cost of disease in CKD and increasing the quality of life of patients.

Keywords

• anthropometric measurements
• nutrition
• biochemical parameters
• chronic kidney disease
• inflammation score

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