the comparison between bioimpedance parameter and m.i.s ... 152 the comparison between...high mis...
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BackgroundMalnutrition is important cause of morbidity and mortality indialysis patients. Early diagnosis of malnutrition in dialysis patientsis extremly important for success of nutritional therapy.Malnutritioninflammation score is useful, simple, but timeconsuming questionary for diagnosis of malnutrition, sarcopeniaand cahexia.
The comparison between bioimpedance parameterand M.I.S* in dialysis patients
Marija Madroniè, medical nurseDialysis Center, Clinical Department of Nephrology, University Medical Center Ljubljana, Zalo�ka street 7, Slovenia
Figure. MIS. *Major comorbid conditions include congestive heart failure class III or IV, fullblown AIDS, severe coronary artery disease, moderate to severe chronic obstructivepulmonary disease, major neurologic sequelae, and metastatic malignancies or s/p recentchemotherapy. Suggested equivalent increments for serum transferrin are 200 (0), 170to 200 (1), 140 to 170 (2), and 140 mg/dL.
MethodsMalnutritioninflammation score and bioimpedance body massindices: phase angle (Phi) as prognostic indicator, lean tissue index(LTI), fat tissue index (FTI), overhydration status (OH), arecompared in one Hemodialysis center Ljubljana study (203 patients,L2015 ).
Resultsof linear correlation between MIS and Phase angle are on the picture. High MIS means bad prognosisfor malnutrition and quad vitam but low value of Phi has similar meaninig. Value of Phase angle(Phi)is positive dependent of lean tissue index (LTI), but negative with fat tissue index (FTI), andoverhydration status (OH).
Our experience evaluation methodsurvey M.I.S
Overall evaluation with M.I.Squestionnaire to us for a period of 6months does not give the final results.In addition to the two presentedpatients, I have a short test for alldialysis patients in this center.MIS form reminds us on a patient whomay be malnourished, but it isnecessary to look in more detail,individually. Such a patient may thenbe monthly monitored.It is noticeable that the medicalcondition may deteriorate within twomonths, this is not seen when thishappened in 6.months, or medicalcondition to deteriorate a the end ofmonth, then this result smashes allprevious measurements.Same values of BMI for dialysispatients is not relevant, the result isseductive (example the patient ishypervolemic ... BMI = high, in fact itis worse nourished ... The result,however inaccurate).
M.I.S protocolM.I.S*= protocol � malnutrition, inflamation � the validation of malnutritionAuthor: Alison L. Steiber, PhD, RD, LD, Kamyar KalantarZadeh, MD, PhD, MPH, Donna Secker,MS, RD, Maureen McCarthy, MPH, RD, CSR, LAshwini Sehgal, MD, and Linda McCann, RD,LD. L 2004 Cleveland.
DIALYSIS UKC LJUBLJANA L. 2015Number of patients with a certan value of the MIS
110 = the chronic dialysis patients without associatedacute illnees. Patients with different age period ofdialysis treatment.
1120 = the chronic dialysis patients with signs of poornutrition are also some patients with associated acutedisease, inflammatory responses, including elderlypatients living in DSO and dialysis patients who werehospitalised or had surgery or are had pneumonia.
2030 = chronic dialysis patients( hospital septic, amputees and patientswith serious complications ).
Value M
IS
Author: Marija Madroniè, medical nurse, Dialysis UMC Ljubljana, L 2015
ConclusionNegative significant correlation between Phase angle and malnutritioninflammation score is present. Low values of Phi with negative prognosys in dialysis patients areconnected with high malnutritioninflammation score, which also results in bad prognosis. Phi is useful, simple and fast in showing malnutrition and bad prognosis in dialysispatients. Malnutrition therapy should therefore be started based on bioimpedance body mass compositions results. BIA has good reliability as compared to other acceptedmethods of body composition analysis. Phase angle is a good marker of nutrition status in hemodialysis patients and patients with low values of phase angle need moreintensive observation, diagnostic and nutritional intervention.Dialysis patients is very complex, so a single questionnaire is often insufficient for the actual assessment of the patient? Nutritional status.M.I.S. questionnaire us otherwise extract dietary risk patients, which can then be monitored on a monthly basis / doctor / dietician / nurse.Using BCM us the most accurate information about the patient's nutritional status, details about the actual state of the entire cell body / anabolism / catabolism.
Literature:1. Alison L. Steiber, PhD, RD, LD, Kamyar KalantarZadeh, MD, PhD, MPH, Donna Secker, MS, RD, Maureen McCarthy, MPH, RD, CSR, LAshwini Sehgal, MD, and Linda McCann, RD, LD. L 2004 Cleveland.2. Subjective Global Assessment in Chronic Kidney Disease: A ReviewAlison L. Steiber, PhD, RD, LD, *Kamyar KalantarZadeh, MD, PhD, MPH, Donna Secker, MS, RD, Maureen McCarthy, MPH, RD, CSR, LD,§ Ashwini Sehgal, MD,and Linda McCann, RD, LD. L 2004, CASE School of Medicine [email protected], WG38 Cleveland, OH 44106 Alison Steiber is a registered dietitian who completed a B. S. In dietetics at Minnesota State at Mankato, a dietetic internship and M.S. in Human Nutrition at The University of Kansas Medical Center, and a Ph.D. in Nutrition from Michigan State University. Prior to joining the faculty at Case Western Reserve University she was a Manager of Nutrition Services for a dialysis center and a clinical dietitian in a medical center. Dr. Steiber's areas of interest are nutritional assessment, chronic kidney disease and carnitine.3. Malnutrition �inflammationscore Is Corelated with Morbidity and Mortality in Maintenance Hemodialysis Patients. American Journal of Kidney Diseasers, Vol 38, No 6 (December), 2001: pp 1251 �1263.4. Dialysis Paper individual patient to be treated with Hemodialysis,.L 2015 Januar, UKC Ljubljana.5. Wolfson, M, Strong, CJ, Minturn, D, Gray, DK, Kopple, JD: Nutritional status and lymphocyte function in maintenance hemodialysis patients. Am J Clin Nutr 1984 39:547�555, | PubMed | ISI | ChemPort |6. Cano, N, Fernandez, JP, Lacombe, P, Lankester, M, Pascal, S, Defayolle, M, Labastie, J, Saingra, S: Statistical selection of nutritional parameters in hemodialysed patients. Kidney Int Suppl 1987 22:S178�S180, PubMed | ChemPort |
Author: Marija Madroniè, medical nurse, Dialysis UMC Ljubljana, L 2015
univerzitetniklinièni center ljubljana