대한신장학회

논문분류	춘계학술대회 초록집
제목	A Comparative Analysis of the Global Leadership Initiative on Malnutrition and Subjective Global Assessment for Diagnosing Malnutrition among Predialysis and Dialysis Inpatients
저자	Lulu Octaviani
출판정보	2024; 2024(1):
키워드
초록	Objectives: Malnutrition is a severe complication in chronic kidney disease (CKD) patients. In Indonesia, the prevalence of malnutrition in predialysis and dialysis patients is 70% and 16-54%, respectively. The 2020 KDOQI guidelines recommend subjective global assessment (SGA) to assess nutritional status and diagnose malnutrition in kidney disease patients. Although recommended, SGA has several biases in end-stage CKD patients. In 2018, the Global Leadership Initiative on Malnutrition (GLIM) created a new standard for diagnosing malnutrition. This study aimed to determine the prevalence of malnutrition in predialysis and dialysis inpatients and to evaluate the performance of GLIM criteria towards SGA in diagnosing malnutrition. Methods: In total, 106 subjects aged 18-59 years were included in this cross-sectional study. This study was conducted in the Internal Medicine Wards of Dr. Cipto Mangunkusumo National Central General Hospital from January to December 2023. Malnutrition was diagnosed with GLIM and SGA. Diagnostic performance tests were performed by analyzing sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Area Under the Curve (AUC), and Cohen’s kappa coefficient. Results: The subjects in this study consisted of 89.6% male, 10.4% female, 27.4% in early adulthood, and 72.6% in late adulthood. Malnutrition was diagnosed in 51.9% of the subjects by GLIM and 53.8% by SGA. In further detail, the prevalence of malnutrition by GLIM in predialysis and dialysis inpatients was 53.7% and 45.8%, respectively. The prevalence of malnutrition by SGA in predialysis and dialysis inpatients was 56.1% and 45.8%, respectively. GLIM showed good validity with 96.5% sensitivity, 100% specificity, 100% PPV, 96% NPV, and 0.98 AUC towards SGA. Cohen’s kappa coefficient (k) showed “almost perfect agreement” (k = 0.96). Conclusions: This study indicates that GLIM accurately diagnoses malnutrition in predialysis and dialysis inpatients. GLIM has almost perfect agreement with SGA, so it can be used to diagnose malnutrition in hospital care settings.
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