Malnutrition Evaluation in Elderly Hemodialysis Patients; Single Center Data

Öz

Aim: With the increase in the elderly population in our country, as in the whole world, the number of elderly patients receiving hemodialysis treatment is increasing. Since nutritional problems
increase mortality and morbidity in elderly hemodialysis patients, early diagnosis and initiation of treatment are of great importance. Our aim; In addition to determining the prevalence of malnutrition in elderly patients receiving hemodialysis treatment, we aimed to evaluate the effectiveness of MiniNutritional Assessment-Short Form (MNA-SF) and body mass index (BMI) tests in identifying patients with nutritional deficiency. Materials and Method: A total of 123 patients aged 65 and over, 66 (69.24±5.68) men and 57 (71.01±7.50) women, were included in this cross-sectional study. Anthropometric, clinical and laboratory data of the patients were obtained from medical files. Patients were evaluated with Mini-Nutritional AssessmentShort Form and body mass index. Results: According to Mini-Nutritional Assessment-Short Form, 44 (35.7%) patients were considered malnutrition, 53 (43.1%) patients were at risk for malnutrition, and 26 (21.2%) patients were
considered to have a normal nutritional status. A statistically significant difference was found between all three groups in terms of weight and body mass index (respectively; p<0.001, p<0.001).
Body mass index <23 was calculated for 45 (36.6%) of the patients participating in the study. A positive correlation was found between Mini-Nutritional Assessment-Short Form and body mass index and weight (respectively; r= 0.701, p<0.001 and r=0.612, p<0.001). Conclusion: Although there is a strong and significant relationship between body mass index and malnutrition in hemodialysis patients, the use of body mass index alone is insufficient to diagnose malnutrition. In the evaluation of nutritional status in elderly hemodialysis patients, body mass index should not be used alone,
but should be used together with screening tests with proven validity and reliability such as Mini-Nutritional Assessment-Short Form.

Anahtar Kelimeler

• elderly
• hemodialysis
• malnutrition
• MNA-SF;BMI

Yaşlı Hemodiyaliz Hastalarında Malnütrisyon Değerlendirmesi; Tek Merkez Verileri/Malnutrition Evaluation in Elderly Hemodialysis Patients; Single Center Data

Öz

Amaç: Tüm dünyada olduğu gibi ülkemizde de yaşlı nüfusun artışıyla hemodiyaliz tedavisi alan yaşlı hasta sayısı artmaktadır. Yaşlı hemodiyaliz hastalarında beslenme sorunları mortalite ve morbiditeyi arttırdığı için erken dönemde tanı konulması ve tedaviye başlanması büyük öneme sahiptir. Bu çalışma hemodiyaliz tedavisi alan yaşlı hastalarda yetersiz beslenme prevalansını belirlemek ve Mini Nütrisyonel DeğerlendirmeKısa Formu ile vücut kütle indeksinin beslenme yetersizliği olan hastalardaki etkinliğini değerlendirmek amacıyla yapıldı. Gereç ve Yöntem: Bu kesitsel çalışmaya 65 yaş ve üstü, 66’sı (69,24±5,68) erkek ve 57’si (71.01±7.50) kadın toplam 123 hasta dahil edildi. Hastalara ait antropometrik, klinik ve laboratuvar verilere tıbbi dosyalardan ulaşıldı. Hastalar Mini Nütrisyonel Değerlendirme-Kısa Formu ve vücut kütle indeksi ile değerlendirildi. Bulgular: Mini Nütrisyonel Değerlendirme-Kısa Formuna göre 44 (%35,7) hastada malnütrisyon, 53 (%43,1) hasta malnütrisyon, yönünden riskli, 26 (%21,2) hasta normal beslenme durumu olarak değerlendirildi. Her üç grup arasında vücut ağırlığı ve vücut kitle indeksi açısından istatistiksel olarak anlamlı fark saptandı (sırasıyla; p<0.001, p<0.001). Çalışmaya katılan hastaların 45(%36,6)’inin vücut kitle indeksi <23 hesaplandı. Mini Nütrisyonel Değerlendirme-Kısa Formu ile vücut kitle indeksi ve kilo arasında pozitif korelasyon saptandı (sırasıyla; r= 0.701, p<0.001 ve r=0.612, p<0.001).
Sonuç: Hemodiyaliz hastalarında vücut kitle indeksi ile malnütrisyon arasında güçlü bir anlamlı ilişki olmasına rağmen, vücut kitle indeksinin tek başına kullanımı malnütrisyon tanısı koymada yetersiz kalmaktadır. Yaşlı hemodiyaliz hastalarında beslenme durum değerlendirmesinde vücut kitle indeksi tek başına değil, Mini Nütrisyonel Değerlendirme-Kısa Formu gibi geçerliliği ve güvenilirliği kanıtlanmış tarama testleri ile birlikte  kullanılmalıdır.

Anahtar Kelimeler

• yaşlı
• hemodiyaliz
• malnutrisyon
• MNA-SF;VKİ

Kaynakça

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