Subjective Global Assessment of Nutrition in Maintenance Hemodialysis Patients

Kim, Jae Hi; Kim, Sung Rok

Abstract

Protein and energy malnutrition are common in dialysis patients. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increased morbidity and mortality in both hemodialysis and peritoneal dialysis. To validate subjective global assessment(SGA) in dialysis patients we compared subjective global assessment with objective measurements(anthropometry, bioelectrical impedance, biochemical measurements) in 54 chronic hemodialysis patients. We divided patients into three groups(SGA1, SGA2, SGA3) according to modified subjective global assessment performed by an observer. Body weight, %IBW, BMI, TSF, MAC, nPCR were different significantly among three groups. SGA was related objective measurements such as body weight, %IBW, BMI, %Fat, TSF, MAC, nPCR(p<0.001). Multiple regression analysis showed that the relationship of SGA(as a dependent variable) with objective measurement(covariate) was stronger(multiple r=0.789, R2=60%) than the relationship found with univariate analysis. In other words, since no single objective method can be considered a gold standard of nutritional assessment, our data show that subjective global assessment is a clinically adequate method for assessing nutritional status in maintenance hemodialysis patients.