The relationship between patient-based SGA and MNA with prealbumin in geriatric hemodialysis patients

Aim: It is basically characterized by reducing the reserve biological capacity as well as 65 years and over is accepted as senility. The elderly population is growing rapidly all over the World. The increase in the elderly population among patients who undergp renal replacement terapy due to chronic kidney disease is much higher than other age groups. The geriatric population is a very sensitive group to nutritional insufficiency. Besides the physiological process, nutritional habits in old age are also affected by chronic diseases, medicines and physical, mental, social determinants. Malnutrition is common in patients with chronic kidney disease and there is a strong relationship between malnutrition and mobidity and mortality. Therefore malnutrition in the geriatric population should be well assessed and treated. Prealbumin, a carrier protein for thyroxine is used to evaluate malnutrition in various patient populations. In our study for this purpose, we aimed to reveal the relationship between patient-based sga and mna with prealbumin in geriatric hemodialysis patients who we followed up and treated. Material and Method: In our study, Inonu University Turgut Özal Medical Center Hemodialysis Unit and Malatya Training and Research Hospital included 49 patients who were 65 years of age or over without active infection, a total of 225 patients who had hemodialysis three times a week for at least 3 months due to chronic kidney disease. The patients age, height, weight, body mass index, upper arm circumference, calf circumference, edema presence, muscle mass loss and whole blood, biochemistry, ferritin, parathormone, prealbumin levels were examined. These patients were sujected to patient- based sujective global analysis and mini-nutritional analysis tests and score environments were recorded. In our statistical evaluation of our research data, SPSS for Windows version 22.0 software was used. Results: 49 patients (18 males and 31 females) were included in the study. There was no statistically significant difference between male and female patients in terms of body mass index, arm circunference and calf circumference (respectively; p=0.446, p=0.565, p=0.939), diabetes was present in twenty of the patients included in the study. There was no statistically significant difference in albümin and prealbumin levels between diabetic and non-diabetic patients. When patients were grouped according to PGSGA scores, there were 13 patients in the well-fed group, 33 patients in the middle malnutrition group and 3 patients in the severe malnutrition group. There was no significant difference between the groups in terms of body mass index, arm circumference and calf circumference of the patients according to PGSGA groups (respectively; p=0.231, p=0.330, p=0.439). Albümin, creatinin and MCV values in the severe malnutrition group were lower when compared to other groups (respectively; p=0.05, p=0.002, p=0.013). There was no statistically significant difference between PGSGA groups in terms of prealbumin levels (p=0.850). There was a statistically significant difference between groups of PGSGA in terms of MNA scores were lover in the severe malnutrition group(p=0.007). There was a statistically significant positive correlation between MNA scores and body mass index, arm circumference and calf circumference (respectively; p=0.0030, r=0.31; p=0.007, r=0.379; p=0.007, r=0.379). There was a statistically significant positive correlation between MNA and prealbumin levels (p=0.045, r=0.287). Conclusion: Although studies have shown that SGA is a good parameter for nutritional status in patients with chronic kidney disease, it has been found that MNA has a better correlation with nutritional parameters and anthropometric measurements in our study.