Ravi Shankar Bonu
Manipal Hospitals, India
: J Kidney
Nutritional status assesment in dialysis patients is very important since malnutrtion in dialysis is common and increases morbidity and mortality.The commonly used mehtods such as; BMI, anthropometry are not accurate for assessing the nutritional status in dialysis patients because of their altered fluid status. However, adding subjective global assessment (SGA) or malnutrition inflammatory score (MIS) to anthropmetry may provide better information. The fat mass, fat free mass (lean body mass) are the two most important parameters of nutrition and can be abnormal even with normal body weight in dialysis patients. DEXA scan, CT, MRI which are relatively simple methods to perform but involve expertise to analyze the data are a bit more expensive and expose patients to ionizing radiation. More accurate methods such as dueterium oxide and total body potassium estimation are complex, and used as advanced tools. Bioimpedance analysis (BIA), a relatively simpler, cheaper, bedside and user freindly tool has become more popular in the recent past in assesing the nutritional status in dialysis patients. In our expereince, bioimpedance analysis yielded body composition parameters which correlated well with BMI and anthropometric parameters in a subset of our dialysis patients. In addition, we found that subjective global assesment is also a less expensive method and provided nutritional as well as functional status in our dialysis patients. We conclude that, in our experience, bioimpedance analysis and subjective global assessment are simple tools and are complimenary to anthropometry for nutritional assesment in dialysis patients.
Ravi Shankar Bonu has completed his MBBS from Andhra Medical College, Vishakapatnam, Andhra Pradesh, India. He did his MD in Internal Medicine from PGIMER, Chandigarh, India. He has done DM (Nephrology) training at Osmania General Hospital, Hyderbad, India. He also had a short stint at Toronto General Hospital, Toronto, Canada in 2007. Currently, he is a Senior Consultant at Manipal Group of Hospitals, Bangalore, India. He has 20 years of experiene in Nephrology and has been a Teacher for Nephrology Trainining Programme in India and he has publications in national and international journals