Multicenter Study to Validate a Hospitalization Risk Assessment Tool in Hemodialysis Patients

Area of Science:

• Nephrology
• Clinical Nutrition
• Public Health

Background:

• Protein-energy wasting (PEW) is common in chronic kidney disease (CKD) patients.
• Early identification of PEW is crucial for managing CKD complications.
• Existing risk assessment tools may lack ease of application or cost-effectiveness.

Purpose of the Study:

• To validate the Hashmi's tool for risk assessment of PEW in maintenance hemodialysis (HD) patients.
• To evaluate the tool's applicability and cost-effectiveness across multiple centers.
• To correlate risk scores with hospitalization and mortality rates.

Main Methods:

• A multi-center validation study involving 868 maintenance HD patients over two years.
• Utilized Hashmi's tool, scoring variables like BMI, HD vintage, albumin, and comorbidities.
• Patients categorized into low-risk (<6) and high-risk (≥6) groups; outcomes compared using chi-square test.

Main Results:

• The Hashmi's tool identified 439 high-risk and 429 low-risk patients.
• High-risk patients, particularly those with diabetes and hypertension, showed significantly higher rates of hospitalization (p=0.036 for vascular, p<0.001 for non-vascular).
• Mortality was three times higher in the high-risk group (p<0.001).

Conclusions:

• Hashmi's tool is a validated, simple, and cost-effective method for identifying malnourished CKD patients at risk.
• The tool accurately predicts hospitalization and mortality in maintenance HD patients.
• This multi-center validation supports its widespread use in dialysis units across Saudi Arabia.