EFFECT OF MEDICAL NUTRITION THERAPY ON NUTRITIONAL STATUS OF CHRONIC KIDNEY DISEASE UNDER HAEMODIALYSIS ASSESSED BY MIS TOOL: A PRE-POST INTERVENTIONALSTUDY IN TERTIARY HOSPITAL OF NEPAL
DOI:
https://doi.org/10.37268/mjphm/vol.26/no.1/art.3629Keywords:
Nutritional status, Chronic Kidney Disease, Malnutrition Inflammation Score, C-reactive ProteinAbstract
Chronic kidney disease (CKD) remains a major global public health challenge, accounting for approximately 1.48 million deaths worldwide in 2023 and ranking as the ninth leading cause of death globally. The global prevalence of CKD is estimated at 9.1%, with advanced disease being less common, as CKD stage 5 affects about 0.07% of the population and 0.041% requiring dialysis.The estimated annual incidence of end-stage kidney disease in Nepal is approximately 2,900 new cases, highlighting the growing need for effective prevention and management strategies. Thisstudy aims to evaluate the prevalence of Protein-Energy Wasting (PEW) using serum albumin, C-reactive protein (CRP) for inflammation, and the Malnutrition Inflammation Score (MIS) both before and after medical nutrition therapy intervention. It also explores the relationship between Malnutrition Inflammation Score, C - reactive protein, and serum albumin in patients undergoing haemodialysis. The study involved 83 chronic haemodialysis patients from Kist Medical College and Teaching Hospital, Imadol, Gwarko, Nepal.Patients were divided into two categories: adequately nourished and malnourished. Initially, only 22% of patients were adequately nourished, while 78% were classified as malnourished. Following dietary counselling, monitoring and evaluation, the proportion of adequately nourished patients on haemodialysis increased significantly to 80%.Paired sample t-test were used to compare pre and post intervention values, and results are interpreted as mean differences with 95% confidence intervals.MIS scores significantly decreased (mean difference=9.76;95%CI:8.4 to 11.2;p<0.001) at twelve months. The study found a strong negative correlation between MIS and albumin levels (r = -0.661, p = 0.01). Furthermore, moderate positive correlation was detected between CRP and MIS in haemodialysis patients (r = 0.454, p = 0.01). This study highlights that dietary counselling and regular monitoring help increase protein intake, enhance serum albumin levels, reduce inflammation, and decrease muscle wasting, leading to improved nutritional status in patients.
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