Clinical Evaluation of Protein Energy Wasting in Maintenance Hemodialysis Patients

Background: Protein-energy wasting (PEW) is a common complication of maintenance hemodialysis (MHD) patients. This study aimed to explore the PEW evaluation method in MHD patients. Methods: : Clinical data, physical parameters, laboratory values, and a questionnaire survey of MHD patients were collected from PEW and non-PEW patients in our hospital from September to December 2019. Analysis of variance was used to assess the difference between the two groups. ROC analysis was used to compare the diagnostic efficacy of physical measurement and nutrition scores and find the appropriate evaluation criteria for clinical application. Results: : 1. There were statistically significant differences in many physical parameters between the two groups (p<0.05). 2. ROC curve analysis showed that the diagnostic efficiency of a single physical measurement or nutritional score was not high, and multiple indexes should be combined. 3. The simplified Pew risk score formula was 27.4 + abdominal circumference + 0.4 * main handgrip strength - 3.2 * body mass index -1.9 * upper arm circumference, which had a sensitivity of 67.7% and specificity of 94.4% at AUC of 0.864 and cutoff of 0.043346. Conclusion: A combination of abdominal circumference, main handgrip strength, BMI, and upper arm circumference could comprehensively evaluate PEW to improve the diagnostic efficiency.