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Enfermería Nefrológica

versión On-line ISSN 2255-3517versión impresa ISSN 2254-2884

Resumen

ELVIRA CARRASCAL, Sonia et al. Description of the nutritional state of patients in a dialysis unit using the Malnutrition Inflammation Score. Enferm Nefrol [online]. 2013, vol.16, n.1, pp.23-30. ISSN 2255-3517.  http://dx.doi.org/10.4321/S2254-28842013000100004.

Introduction: Malnutrition is a very frequent health problem in the population with chronic kidney insufficiency receiving dialysis. Given the high prevalence of malnutrition in dialysis patients and its effect on morbi-mortality of patients, it is necessary to establish an adequate monitoring of nutritional aspects for early detection of patients at risk or with nutritional deficit and carry out an early nutritional intervention that will manage to reverse the situation. Objetives: • To describe the nutritional state of patients attended at the dialysis unit of the nephrology service of the Consorcio Hospitalario de Vic, according to the Malnutrition Inflammation Score for a period of 2 years. • To describe the socio-demographic and clinical features of dialysis patients in the Consorcio Hospitalario de Vic whose nutritional state was assessed using the Malnutrition Inflammation Score. • To analyse whether factors such as gender, age, type of dialysis treatment, the presence of comorbility, the type of haemodialysis access, the time on dialysis, the number of hospitalizations or total number of days hospitalized are related to the nutritional state of dialysis patients at the Consorcio Hospitalario de Vic, according to the Malnutrition Inflammation Scores obtained. Material and methods: Prospective transversal study. Carried out at the Nephrology Unit of the Consorcio Hospitalario de Vic. Patients diagnosed with chronic kidney disease and who undergo dialysis were studied, and dialysis patients with treatment records of more than three months were included. The study was carried out from January 2009 to December 2010. Socio-demographic variables (age, gender, type of dialysis treatment, origin of the renal pathology, existence of history of comorbility, access used for haemodialysis, situation of dialysis treatment, cause for end of dialysis treatment), the nutritional state according to the Malnutrition Inflammation Score and consumption of resources (number of hospitalizations per year, total number of days hospitalized per year, time on dialysis) were analysed. The data were obtained from the computerized records of the nephrology service. The SPSS v.18.0. programme was used for the statistical analysis. Results: 130 patients were analysed, which corresponded to the total number of patients assessed according to nutritional state using the Malnutrition Inflammation Score during 2009 and 2010. Of these, 79 (60.8%) were men and 51 (39.2%) were women, the average age was 64.76 ± 14.27 years, and 18.5% of the patients were malnourished. Of the total of 130 patients analysed, 399 Malnutrition Inflammation Score values were obtained. From 69 (53.1%) of them, there were 4 scores, from 18 (13.8%) there were 3 scores and for 26 (20,0%) there were 2 and for 17 (13.1%) there was only one. It was observed that 353 (88.5%) of the scores were classified as well-nourished and 46 (11.5%) as malnourished. The mean scores on the Malnutrition Inflammation Score scale according to the number of records (from the first to the fourth) were: 6.29 ± 3.65, 6.06 ± 2.91, 6.38 ± 3.13 and 7.96 ± 3.50 respectively, with statistically significant differences being observed (p=0.001). The nutritional evolution of 113 patients (86.9%) was analysed, who were those who had more than one record of Malnutrition Inflammation Score. The scores of the first and last record were taken into account. The average score for the first records was 5.96 ± 3.34 compared to the average for the final scores which was 7.50 ± 3.62, these differences being statistically significant (p<0.001). Conclusions: • We would highlight the importance of knowing the nutritional state of chronic kidney insufficiency patients receiving haemodialysis and peritoneal dialysis treatment due to the risk of presenting associated morbi-mortality. • The Malnutrition Inflammation Score is a good instrument for assessing nutritional state, facilitating the care of dialysis patients. • The time on replacement therapy and the presence of comorbility are two of the main aspects to take into consideration when controlling the nutritional state of patients with chronic kidney disease. • Studies should continue to be carried out on the application of the Malnutrition Inflammation Score in assessing the nutritional state and the level of evidence should be modified.

Palabras clave : Undernutrition; Malnutrition; MIS (Malnutrition Inflammation Score); Comorbility; Nutritional state.

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