Assessment of nutritional status in chronically dialyzed patients: high prevalence of malnutrition based on subjective global assessment, simplified nutritional appetite questionnaire, anthropometry and serum albumin analysis - a cross-sectional study.

INTRODUCTION

Malnutrition is common in dialysis patients and is associated with increased morbidity and mortality. Body Mass Index (BMI) may underestimate nutritional disturbances; therefore, multidimensional assessment is recommended. This study evaluated nutritional status, appetite and risk of weight loss in chronically dialyzed patients, and compared different methods, Subjective Global Assessment (SGA), Simplified Nutritional Appetite Questionnaire (SNAQ), anthropometry and biochemical markers.

METHODS

A total of 105 chronically dialyzed patients were included (88.6% on hemodialysis, 11.4% on peritoneal dialysis). Nutritional status was assessed using SGA (seven-point scale), SNAQ, anthropometry (BMI, mid-arm circumference), and serum concentrations of albumin and C-reactive protein (CRP) as the markers of nutritional and inflammatory status. The Shapiro-Wilk test was used for normality; group comparisons employed Student's t-test or Mann-Whitney U test and Kruskal-Wallis ANOVA for multiple groups. Correlations were analyzed using Spearman's coefficient.

RESULTS

Malnutrition, according to SGA (≤5 points), was present in 54.3% of patients, whereas BMI <20 kg/m2 was observed in only 9.8%. Among those with low BMI, 90% were malnourished by SGA, and 60% had appetite impairment. Appetite disorders (SNAQ ≤14 points) occurred in 42% of patients and were associated with lower albumin levels, smaller mid-arm circumference and lower body weight . BMI positively correlated with SGA, SNAQ and albumin.

CONCLUSIONS

Malnutrition is highly prevalent in Polish dialysis patients and is linked with appetite impairment, elevated CRP, reduced albumin and poorer clinical status. BMI alone is insufficient to detect nutritional disturbances. Regular use of multidimensional tools (SGA, SNAQ, albumin) should be employed to enhance the early detection and management of malnutrition in patients with end-stage kidney disease (ESKD).