Jundishapur Scientific Medical Journal

Jundishapur Scientific Medical Journal

Compression of Three Different Methods (Subjective Global Assessment, Bioelectric Impedance Analysis and Biochemical Indices) In Assessing Nutritional Status in Pediatric and Young Adult with Chronic Kidney Disease

Document Type : Original Article

Authors
Maryam Ranjbar Zahedani 1
Mohammad Hassan Eftekhari 1
Mitra Basirat Nia 2
Abbas Rezayian Zadeh 3
Shiva Faghih 4
1 Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
2 Department of Pediatrics, Research Center of Kidney and Nephrology, Shiraz University of Medical Sciences, Shiraz, Iran.
3 Department of Epidemiology, Health Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
4 Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
Background and Objective: Protein-energy malnutrition (PEM) is one of the most prevalent problem in renal patients that can decrease quality of life and increase mortality in these patients. The aim of this study was to compere three different methods of nutritional assessment for evaluation the nutritional status of these patients.
Subjects and Methods: In this study, 30 pediatric patients with chronic kidney disease (6 to 20 years) with GFR=15-60 ml/min/1.72m2 were selected and compared with 30 healthy control subjects. Nutritional assessment was made by use of subjective global assessment (SGA), measuring serum albumin, pre-albumin, IGF-I and body composition analysis performed by bioelectric impedance analysis (BIA) method. The data were analyzed using SPSS software, normally distributed variables were expressed as mean ± Standard Deviation (SD) and were compared by Independent Student’s t-test. means were considered significantly different at P<0.05.
Results: Based on SGA score none of CKD patients had severe malnutrition. Mean albumin and IGF-1 level, were significantly lower in CKD children. BIA results showed patients with CKD had significantly lower dry lean weight, body cell mass, body mass index and basal metabolic rate.
Conclusion: The result of present study showed BIA compared with SGA and biochemical factors is more effective in early detection of malnutrition in CKD children. Therefore this study suggests that BIA can be an attractive clinical tool to detect malnutrition in CKD.
 
Keywords
Protein Energy Malnutrition
Chronic kidney disease
children
1-Asgarani F, Mahdavi-Mazdeh M, Lessan-Pezeshki M, Makhdoomi A, Nafar M. Correlation between modified subjective global assessment with anthropometric measurements and laboratory parameters. Acta Medical Iranica 2004; 42 (5): 331-337.
2-Mutsert R,  Grootendorst DC,  Boeschoten EW,  Brandts  H, Van Manen JG, Raymond T Krediet RT, ‘et al’. Subjective global assessment of nutritional status is strongly associated with mortality in chronic dialysis patients. Am J Clin Nutr2009; 89( 3): 787-793.

3-Kovesdy CP, Kopple JD, Kalantar-Zadeh K. Management of protein-energy wasting in non-dialysis-dependent chronic kidney disease: reconciling low protein intake with nutritional therapy. Am J Clin Nutr  2013; 97(6): 1163-77.

4-Besbas N¸ Ozdemir S, Saatci U¸ Coskun T, Ozen S, Topaloglu R, Bakkaloglu A, Nahas M. Nutritional assessment of children on haemodialysis: value of IGF-I, TNF-α and IL-1β. Nephrol Dial Transplant 1998; 13: 1484–1488.
5-Mahan L, Esscot-stump, Raymond J. Krause’s food and nutrition care process.13th ed. United States of America: Elsevier; 2012.
6-Mitch, William E. Handbook of nutrition and the kidney. 3th ed. Philadelphia: Lippincott Williams and Wilkins; 2002.
7-Foster BJ, Leonard MB. Measuring nutritional status in children with chronic kidney diseases. American Journal of Clinical Nutrition 2004 Oct; 80(4): 801–14.
8-Li Y, Dong J, Zuo L. Is subjective global assessment a good index of nutrition in peritoneal dialysis patients with gastrointestinal symptoms?. Peritoneal Dialysis International 2009; 2:78-82.
9-Tabibi H, As'habi A, Nazari B, Mahdavi-mazdeh M, Hedayati M, Abdollahi M. comparision of various methods for determination of protein-energy malnutrition with subjective global assessmrnt in hemodialysis patients. Iranian journal of nutrition and food science 2010; 4:13-22[in Persian].
10-Jones CH, Wolfenden RC, Wells LM. Is subjective global assessment a reliable measure of nutritional status in hemodialysis? J Ren Nut 2004; 14(1):26-30.
11-Ekim M, Ikinciogullari A, Ulukol B, Bakkaloglu SA, Ozkaya N, Kendirli T, ‘et al’. Evaluation of nutritional status and factors related to malnutrition in children on CAPD. Peritoneal Dialysis International 2003; 23: 557–562.
12-Abdullah MS, Wild G, Jacob V, Milford-Ward A, Ryad R, Zanaty M, ‘et al’. Cytokines and the malnutrition of chronic renal failure. Am J Kidney Dis 2000; 35: 105-36.
13-Bellizzi V, Scalfi L, Terracciano V, De Nicola L, Minutolo R, Marra M, ‘et al’. Early changes in bioelectrical estimates of  body composition in chronic kidney disease. J Am Soc Nephrol 2006; 17: 1481-1487.
14-Bonanni A, Mannucci I, Verzola D, Sofia A, Saffioti S, Gianetta E, ‘et al’. Protein-Energy Wasting and Mortality in Chronic Kidney Disease.  Int J Environ Res  Public Health 2011; 8: 1631-1654.
15-Cano NJ, Miolane-Debouit M, Léger J, Heng AE. Assessment of body protein: energy status in chronic kidney disease. Semin Nephrol 2009 Jan; 29(1): 59-66.
16-Slee AD. Exploring metabolic dysfunction in chronic kidney disease.Nutrition & Metabolism 2012;  9(36): 1-16. 

17-Garibotto G1, Sofia A, Saffioti S, Bonanni A, Mannucci I, Verzola D. Amino acid and protein metabolism in the human kidney and in patients with chronic kidney disease. Clin Nutr 2010 Aug; 29(4): 424-33.

18-Kaskel F. Chronic renal disease: A growing problem. Kidney Int 2003; 64: 1141-1151.
 
Jundishapur Scientific Medical Journal
Volume 13, Issue 4 - Serial Number 91
July and August 2014
Pages 399-408

  • Receive Date 28 September 2013
  • Revise Date 11 May 2014
  • Accept Date 08 June 2014