Authors (including presenting author) :
Kong TL(1)(2)
Affiliation :
(1)Integrated Rehabilitation Services - Dietetic Department, Tseung Kwan O Hospital (2)Hemodialysis Centre, Tseung Kwan O Hospital
Introduction :
Malnutrition is commonly observed among hemodialysis patients with a prevalence as high as 75%. It is also an independent indicator of morbidity and mortality among them.
Objectives :
(1) To assess the malnutrition risk among a cohort of chronic hemodialysis patients in Hemodialysis Centre (HDC) at Tseung Kwan O Hospital (TKOH) in July 2022.
(2) To review whether dietitian input following evidence-based guidelines would reduce malnutrition risk among high-risk dialysis patients.
Methodology :
A cross-sectional study was conducted among the hemodialysis patients in TKOH. A descriptive malnutrition screening was performed by trained dietetic assistants with patient-generated subjective global assessment (PG-SGA) at baseline. Individualized nutrition counselling by a trained dietitian was provided to high-risk patients with PG-SGA score >/=9 within 2 weeks with subsequent follow-ups. The post-intervention PG-SGA scores were obtained in around 1-year period.
Result & Outcome :
Total 35 hemodialysis patients (15 females and 20 males) with mean age 63 +/- 10 years were recruited for malnutrition screening at baseline. 2 males was excluded due to refusal and cognitive deficit. 30.3% of patients (n=10, 5 females and 5 males) showed high risk of malnutrition (PG-SGA score >/= 9) with critical needs for improved nutrient intervention. 48.5% of patients (n=16, 6 females and 10 males) showed moderate risk of malnutrition (PG-SGA score 4-8). 18.2% of patients (n=6, 3 females and 3 males) were at low risk of malnutrition (PG-SGA score 2-3). Only 1 female (3%) was not at risk of malnutrition (PG-SGA score 0-1).
The 10 high malnutrition risk hemodialysis patients (with PG-SGA score ranged 10-19) proceeded to intervention. 4 patients showed PG-SGA scores reduced to 4-8, which implied the malnutrition risk was improved from high to moderate level. 1 patient showed PG-SGA score reduced to 2, implying not at risk of malnutrition. 1 individual was excluded from the post-assessment due to cognitive decline, while 4 high-risk patients passed away before the re-assessment. Among the 5 high-risk patients audited at the 1-year interval, a decrease of PG-SGA score ranged from 10-19 to 2-8 after dietitian intervention showed a significant reduction in malnutrition risk (p <0.001). Our findings highlight the value of dietitian input for high malnutrition risk patients in chronic hemodialysis setting.
