Original articleThe predictive value of composite methods of nutritional assessment on mortality among haemodialysis patients

SummaryBackground & aimsSeveral parameters might indicate protein-energy wasting in patients undergoing haemodialysis (HD), and such depletion has been associated with the survival of these patients. Our aim was to identify the parameters that are associated with an increased risk of death among HD patients.MethodsThis was a prospective study with at least 13 months follow-up three times per week of 138 HD patients; 61.6% of the patients were men, 28.9% had diabetes mellitus, and 81.9% had hypertension. The associations of the survival rates based on by Kaplan-Meier analysis with the following nutritional parameters were verified: albumin, lymphocytes, % fat mass (% FM), mid-arm muscle circumference (MAMC), subjective global assessment (SGA), malnutrition-inflammation score (MIS), and nutritional risk screening 2002 (NRS 2002). Cox proportional hazard analysis was used to identify the patients' risk of death (hazard proportional ratio - HR).ResultsThe nutritional parameters of lymphocytes and % FM were not associated with the risk of patient death. The patients who were classified as malnourished based on MAMC had a greater risk of death than did those considered nourished, but this difference was not statistically significant. The parameters of serum albumin, SGA, MIS, and NRS 2002 were associated with the risk of patient death (HR = 2.77 P = 0.042, HR = 1.88 P = 0.202, HR = 4.47 P = 0.011, HR = 3.13 P = 0.022, respectively), and the latter two parameters were significantly associated with a high risk among malnourished.ConclusionsThe scores for the MIS and NRS 2002 composite methods of nutritional assessment were associated with the highest mortality risk values; thus, in conditions similar to those of our study, we suggest that the use of these parameters should be preferred.