Background and objectives: Malnutrition is highly prevalent in Malaysian dialysis patients and there is a need for a valid screening tool for early identification and management. This cross-sectional study aims to examine the sensitivity of the Dialysis Malnutrition Score (DMS) and Malnutrition Inflammation Score (MIS) tools in predicting protein-energy wasting (PEW) among Malaysian dialysis patients.
Methods and study design: A total of 155 haemodialysis (HD) and 90 peritoneal dialysis (PD) patients were screened for risk of malnutrition using DMS and MIS and comparisons were made with established guidelines by International Society of Renal Nutrition and Metabolism (ISRNM) for PEW.
Results: MIS cut-off score of >=5 indicated presence of malnutrition in all patients. A total of 59% of HD and 83% of PD patients had PEW by ISRNM criteria. Based on DMS, 73% of HD and 71% of PD patients exhibited moderate malnutrition, whilst using MIS, 88% and 90%, respectively were malnourished. DMS and MIS correlated significantly in HD (r2=0.552, p<0.001) and PD (r2=0.466, p<0.001) patients. DMS and MIS had higher sensitivity values in PD (81% and 82%, respectively) compared to HD (59% and 60%, respectively) patients.
Conclusions: The MIS cut-off scores for malnutrition classification were established (score >=5) for use amongst Malaysian dialysis patients. Both DMS and MIS are valid tools to be used for nutrition screening of dialysis patients especially those undergoing peritoneal dialysis. The DMS may be a more practical and simpler tool to be utilized in the Malaysian dialysis settings as it does not require laboratory markers.
背景与目的：在马来西亚透析患者中，营养不良的发生率很高，需要一种能够 早期识别和管理患者的有效的筛查工具。本横断面研究目的是在马来西亚透析 患者中探讨透析营养不良评分工具（DMS）和营养不良炎症评分工具（MIS） 预测蛋白质能量消耗（PEW）的敏感度。方法与研究设计：用DMS 和MIS 筛 查155 名血液透析（HD）和90 名腹膜透析（PD）患者营养不良的风险，并与 国际肾脏营养与代谢协会（ISRNM）已经制定的PEW 指南进行比较。结果： MIS 截点得分>=5 表示所有的患者存在营养不良。根据ISRNM 标准，59%的HD 和83%的PD 患者有PEW。基于DMS，73%的HD 和71%的PD 患者存在中度 营养不良，而使用MIS，分别有88%和90%的患者为营养不良。在HD（R2 =0.552，p<0.001）和PD（R2=0.466，p<0.001）患者中，DMS 和MIS 显著相 关。与HD 患者相比（分别为59%和60%），PD 患者对DMS 和MIS 有较高的 灵敏度值（分别为81%和82%）。结论：在马来西亚透析患者中，确定了MIS 区分营养不良的截点值（得分>=5）。对于透析患者，尤其是接受腹膜透析的患 者，DMS 和MIS 是有效的营养筛查工具。DMS 可能是用在马来西亚透析装置 中更实用更简单的工具，因为它不需要实验室指标。.