Evaluation of the Appetite and Food Satisfaction Questionnaire (AFSQ); a simple dietary tool to screen for peritoneal dialysis patients with reduced diary intake.

Background

Peritoneal dialysis (PD) patients are at risk of malnutrition due to dietary restrictions and gastro-intestinal effects of dialysis. Aims/

Objectives

Evaluation of the Appetite and Food Satisfaction Questionnaire (AFSQ) which has been proposed as a simple, rapid screening tool to detect PD patients with reduced appetite and food intake.

Methods

The AFSQ, a simple six-question tool combining pictorial images with a Likert scale of 0 to 3 was used to assess dietary protein intake in PD patients, who had contemporaneous body composition measured with bioimpedance, and assessments of dietary protein intake and dialysis adequacy.

Results

AFSQs from 177 PD patients were reviewed, mean age 61.8 ± 15.2 years, 58.2% male, 46.9% diabetic, 36.2% white, median treatment 17 (14-30) months. The median AFSQ score was 5 (3-8), ranging from 0 to 17. Those with highest scores (≥7), had lower normalised dietary protein intake (nPNA) vs those with the lowest scores (0-3) (0.75 ± 0.17 vs 0.88 ± 0.26 g/kg/day), and lower 24-hour sodium removal (103 (48-111) vs 127 (81-168) mmol), P < 0.05. On multi-variable testing higher AFSQ cores were associated with lower nPNA and soft lean mass index (standardised β -0.19 and -0.18, P = 0.031 and 0.036, respectively).

Conclusion

Multi-ethnic PD patients were readily able to complete the simple 6 question AFSQ. Patients with the highest food dissatisfaction scores had lower estimates of dietary protein intake, sodium removal and lean tissue mass. Thus, the AFSQ may have a role as a simple rapid screening tool to highlight PD patients who would benefit from formal dietitian review, particularly in resource limited settings.