A comparison of the full Mini Nutritional Assessment, short-form Mini Nutritional Assessment, and Subjective Global Assessment to predict the risk of protein-energy malnutrition in patients on peritoneal dialysis: a cross-sectional study.

BACKGROUND: The full Mini Nutritional Assessment (full-MNA) and short-form MNA (MNA-SF) are simple and effective nutrition screening scales, but their usefulness for identifying patients with peritoneal dialysis (PD) at risk of protein-calorie malnutrition (PEM) has not been investigated.

OBJECTIVES: This study was aimed to investigate the convergent validity of the full-MNA and MNA-SF for identifying patients with PD at risk of PEM.

DESIGN: A cross-sectional study.

SETTING: A hospital-managed dialysis center.

PARTICIPANTS: 80 adult ambulatory PD patients.

METHODS: Patients were interviewed for personal data and rated with the full-MNA, MNA-SF and the Subjective Global Assessment (SGA) for nutritional status. The consistency among the scales was assessed with kappa coefficients. The ability of each scale to differentiate undernutrition was evaluated with external standards including serum albumin and creatinine concentrations, mid-arm and calf circumferences, and dialysis-related indicators. Statistical significance was evaluated with Wilcoxon rank-sum test.

RESULTS: The full-MNA and MNA-SF showed low agreements with the SGA (kappa=0.346 and 0.185, respectively). The full-MNA and MNA-SF performed better than the SGA in differentiating undernutrition according to the external standards. However, contrary to general expectation, MNA-SF rated a significantly smaller proportion of subjects at risk of undernutrition.

CONCLUSION: The full-MNA and MNA-SF are more able than the SGA in identifying PD patients at risk of PEM. However, MNA-SF rates a smaller proportion of PD patients at risk of undernutrition than the full-MNA. The use of MNA-SF as a stand-alone unit requires further confirmation.