[Subjective general assessment of nutritional status in patients with chronic renal failure and regular hemodialysis].

PATIENTS AND

METHODS

The protein energy malnutrition rating has been investigated in 75 hemodialysis (HD) patients with average treatment period of 67.3 month. A method of subjective global assessment (SGA) of nutritional status was used including body weight and food intake changes evaluated in last six months, as well as the nutritional status in relation to the subcutaneous fat loss and muscle mass wasting. SGA classifies the patients as: A well-nourished, B--mildly malnourished and C--severely malnourished.

RESULTS

Malnutrition was identified in 40%, mild in 34.7% and severe in 5.3% of the patients. In the group of patients with normal nutritional status there were significantly fewer patients with lower values of objective parameters of nutritional status (body mass index (BMI), mid-arm muscle circumference (MAMC), phase angle from bioimpedance measurement, serum albumin) than in the group of patients with severe malnutrition. The differences in these parameters were of marginal significance between the groups with normal nutritional status and with mild malnutrition. The former had a significantly higher BMI value and serum albumin concentrations in comparison to the malnourished patients. There was also a considerable difference in the mean value of C-reactive protein (CRP) among all groups. The rates of malnutrition defined by the SGA method showed a high negative correlation with BMI, MAMC and serum albumin, and high positive correlation with CRP.

CONCLUSIONS

We confirmed the SGA method to be simple to use, and to correlate strongly with other parameters of nutrition. We suggest that the CRP test be included in the assessment of nutritional status to determine the patient inflammatory status, considering the etiologic association between inflammation and malnutrition.