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CHAPTER 7: Nutritional Status on Dialysis Abdul Halim B Abd Gafor Winnie Chee Siew Swee Tilakavati Karupaiah Koh Keng Hee Ahmad Fauzi B Abd Rahman Source:

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Presentation on theme: "CHAPTER 7: Nutritional Status on Dialysis Abdul Halim B Abd Gafor Winnie Chee Siew Swee Tilakavati Karupaiah Koh Keng Hee Ahmad Fauzi B Abd Rahman Source:"— Presentation transcript:

1 CHAPTER 7: Nutritional Status on Dialysis Abdul Halim B Abd Gafor Winnie Chee Siew Swee Tilakavati Karupaiah Koh Keng Hee Ahmad Fauzi B Abd Rahman Source: 21 st MDTR Report 2013, NRR

2 Table 7.1.1: Distribution of serum albumin, HD patients, 2004-2013 Year Number of patients MeanSDMedianLQUQ % patients <30g/L % patients 30-<35g/L % patients 35-<40g/L % patients ≥40g/L 2004 758039.95.3403742.83103453 2005 8705405.240.337.542.8393356 2006 1092739.85.440.337.342.83103354 2007 1231539.75.3403742.53103552 2008 1455139.45.1403742.33103650 2009 1694839.45.1403742.33113551 2010 1875738.94.939.336.341.84134044 2011 2136038.84.939.336.541.54124143 2012 2453138.8539.336.341.54134143 2013 2761438.64.9393641.54134241

3 Source: 21 st MDTR Report 2013, NRR Figure 7.1.1: Cumulative distribution of serum albumin, HD patients 2004-2013 0.25.5.75 1 Cumulative Distribution 253035404550 Serum albumin (g/L) 200520072009 20112013

4 Source: 21 st MDTR Report 2013, NRR Table 7.1.2: Distribution of serum albumin, PD patients, 2004-2013 Year Number of patients MeanSDMedianLQUQ % patients <30g/L % patients 30-<35g/L % patients 35-<40g/L % patients ≥40g/L 2004 128433633.829.537.327323011 2005 134633.26.433.329.53727333010 2006 149833.56.133.8303725333012 2007 175333.66.2343037.825313014 2008 202133.16.433.329.337.328322713 2009 213832.76.4332936.830342511 2010 230532.16.232.328.5363335248 2011 246531.963228.3363534238 2012 280132.66.532.82936.531332710 2013 3173336.633.32937.329312812

5 Source: 21 st MDTR Report 2013, NRR Figure 7.1.2: Cumulative distribution of serum albumin, PD patients 2004-2013 0.25.5.75 1 Cumulative Distribution 20253035404550 Serum albumin (g/L) 200520072009 20112013

6 Source: 21 st MDTR Report 2013, NRR Table 7.1.3: Variation in proportion of patients with serum albumin  40g/L among HD centres 2004-2013 Year Number of centers Min 5 th centile LQMedianUQ 95 th centile Max 2004 20301136597388100 2005 2300114256688597 2006 27601337.553728796 2007 312012365267.585100 2008 3620835506782100 2009 4130936536683100 2010 4440727445979100 2011 505062944577694 2012 549062644587696 2013 6030624415772100

7 Source: 21 st MDTR Report 2013, NRR Figure 7.1.3: Variation in proportion of patients with serum albumin  40g/L, HD centres 2013 0 20 40 60 80 100 % Patients 050100150200250300350400450500550600 Centre (lower 95% CI, upper 95% CI) % with serum albumin >=40g/L

8 Source: 21 st MDTR Report 2013, NRR Table 7.1.4: Variation in proportion of patients with serum albumin  40g/L among PD centres 2004-2013 Year Number of centers Min 5 th centile LQ Media n UQ 95 th centile Max 2004 1822815.52135 2005 19116142329 2006 2211612.5224270 2007 22011214213661 2008 24014.515244151 2009 2500614233537 2010 260029153033 2011 270005213038 2012 280039.5203337 2013 28003823.53240

9 Source: 21 st MDTR Report 2013, NRR Figure 7.1.4: Variation in proportion of patients with serum albumin  40g/L, PD centres 2013

10 Source: 21 st MDTR Report 2013, NRR Table 7.2.1: Distribution of BMI, HD patients, 2004-2013 Year Number of patients MeanSDMedianLQUQ % patients <18.5 % patients 18.5-25 % patients >=25 2004 677523.3922.419.825.4145828 2005 783623.4922.519.825.6145729 2006 979223.37.922.619.925.7145629 2007 1051623.47.922.719.925.8145630 2008 1223223.57.522.820.126135531 2009 1374723.88.22320.126.2135433 2010 1471423.97.823.220.326.5125335 2011 1645724.18.723.320.426.5125335 2012 1833024.38.423.420.526.7115237 2013 1949124.59.123.520.626.9115138

11 Source: 21 st MDTR Report 2013, NRR Figure 7.2.1: Cumulative distribution of BMI, HD patients 2004-2013 0.25.5.75 1 Cumulative Distribution 161820222426283032 BMI (kg/m2) 200520072009 20112013

12 Source: 21 st MDTR Report 2013, NRR Table 7.2.2: Distribution of BMI, PD patients 2004-2013 Year Number of patients MeanSDMedianLQUQ % patients <18.5 % patients 18.5-25 % patients >=25 2004 117523.17.322.619.426195031 2005 1223237.222.519.325.8205030 2006 142023.38.322.619.626.1165033 2007 161723.45.922.919.926.3155134 2008 187423.75.923.220.226.6145036 2009 1946247.123.420.426.8135038 2010 205124.48.823.520.527.1134939 2011 217724.17.823.620.327134938 2012 221224.16.823.520.526.9134938 2013 182224.27.123.520.526.9144838

13 Source: 21 st MDTR Report 2013, NRR Figure 7.2.2: Cumulative distribution of BMI, PD patients 2004-2013

14 Source: 21 st MDTR Report 2013, NRR Table 7.2.3: Variation in proportion of patients with BMI  18.5 among HD centres 2004-2013 Year Number of centers Min 5 th centile LQ Media n UQ 95 th centile Max 2004 1936070828792100 2005 2045870808793100 2006 2575069808692100 2007 2785070818792100 2008 3214072828793100 2009 3565574818893100 2010 3845574838994100 2011 4295975849094100 2012 4786477859194100 2013 5205576869095100

15 Source: 21 st MDTR Report 2013, NRR Figure 7.2.3: Variation in proportion of patients with BMI  18.5 among HD centres 2013

16 Source: 21 st MDTR Report 2013, NRR Table 7.2.4: Variation in proportion of patients with BMI  18.5 among PD centres 2004-2013 Year Number of centers Min 5 th centile LQMedianUQ 95 th centile Max 2004 1828 73838994 2005 1817 6883.58790 2006 22142078849192 2007 2216187686.59197100 2008 2217277888.59195100 2009 2233358089939597 2010 2435 80.5899498100 2011 26 318088939698 2012 24303375.586.592.597100 2013 25193870899497100

17 Source: 21 st MDTR Report 2013, NRR Figure 7.2.4: Variation in proportion of patients with BMI  18.5 among PD centres 2013

18 Source: 21 st MDTR Report 2013, NRR Table 7.2.5: Variation in proportion of patients with BMI  18.5 and serum albumin  40 g/dL among HD centres 2004-2013 Year Number of centersMin 5 th centileLQ Media nUQ 95 th centileMax 2004 1850934506479100 2005 1970133750628090 2006 2420113345.5637991 2007 2690932476072100 2008 308083146597692 2009 3500733476075100 2010 3710625415773100 2011 415052640557192 2012 467052440557190 2013 498042339537294

19 Source: 21 st MDTR Report 2013, NRR Figure 7.2.5: Variation in proportion of patients with BMI  18.5 and serum albumin  40 g/dL among HD centres 2013 10 20 30 40 50 60 70 80 90 100 % Patients 050100150200250300350400450500 Centre (lower 95% CI, upper 95% CI) % with BMI >= 18.5 & ALB >= 40

20 Source: 21 st MDTR Report 2013, NRR Table 7.2.6: Variation in proportion of patients with BMI  18.5 and serum albumin  40 g/dL among PD centres 2004-2013 Year Number of centersMin 5 th centileLQ Media nUQ 95 th centileMax 2004 18115101636 2005 180048.51726 2006 220049.5152052 2007 2201512.5193754 2008 2201310192643 2009 2200511.5173134 2010 240026.5142324 2011 260006142535 2012 240027142638 2013 250018222939

21 Source: 21 st MDTR Report 2013, NRR Figure 7.2.6: Variation in proportion of patients with BMI  18.5 and serum albumin  40 g/dL among PD centres 2013

22 Source: 21 st MDTR Report 2013, NRR Table 7.3.1: Nutritional parameters between HD and PD patients, 2013 HDPD n = 28898 n = 3261 MeanSDMeanSD Age 55.813.750.317.9 Albumin (g/dL) 38.64.933.06.6 BMI 24.59.124.27.1 Total Cholesterol (mmol/L) 4.51.15.01.4 Sr Creatinine ((μmol/L) 812.1238.6841.3318.2 Hemoglobin 10.41.610.41.6

23 Source: 21 st MDTR Report 2013, NRR Table 7.3.2(a): Nutritional parameters between diabetic and non- diabetic HD patients, 2013 DiabetesNon-Diabetes n = 13547n = 15351 MeanSDMeanSD Age 52.315.059.810.7 Albumin (g/dL) 39.14.938.04.8 BMI 23.58.125.69.9 Total Cholesterol (mmol/L) 4.51.04.41.1 Sr Creatinine ((μmol/L) 867.1244.6749.5215.2 Hemoglobin 10.51.610.41.5

24 Source: 21 st MDTR Report 2013, NRR Table 7.3.2(b): Nutritional parameters between diabetic and non-diabetic PD patients, 2013 DiabetesNon-Diabetes n = 947n = 2314 MeanSDMeanSD Age 46.518.859.311.2 Albumin (g/dL) 33.66.631.56.3 BMI 23.46.625.87.9 Total Cholesterol (mmol/L) 5.11.44.91.3 Sr Creatinine ((μmol/L) 883.2326.3738.4271.3 Hemoglobin 10.41.610.61.5

25 Source: 21 st MDTR Report 2013, NRR Table 7.3.3(a): Distribution of serum albumin and BMI by duration of dialysis among HD patients, 2004-2013 Years<11-<55-<10>=10 MeanSDMeanSDMeanSDMeanSD Albumin (g/dL)36.05.538.83.940.03.340.43.0 BMI24.610.824.99.124.27.222.99.2

26 Source: 21 st MDTR Report 2013, NRR Table 7.3.3(b): Distribution of serum albumin and BMI by duration of dialysis among PD patients, 2004-2013 Years<11-<55-<10>=10 MeanSDMeanSDMeanSDMeanSD Albumin (g/dL)32.57.233.35.334.44.335.13.5 BMI24.05.524.58.623.44.421.83.8

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