SUBJECTIVE GLOBAL ASSESSMENT OF NUTRITION IN DIALYSIS PATIENTS

Malnutrition is a major negative prognostic factor in dialysis patient s. Simple and reliable estimations of nutritional status may therefore prove of particular value in the follow-up of these patients. To vali date subjective global assessment (SGA) in dialysis patients we compar ed subjective global assessment with objective measurements (anthropom etry, bioelectrical impedance, biochemical measurements) in 59 chronic uraemic patients treated by haemodialysis (n = 36) or CAPD (n = 23). Subjective global assessment was performed by an observer unaware of t he results of objective measurements and was related to serum albumin (r = -0.51, P<0.001) and bioelectric impedance phase angle (r = -0.58, P<0.001) as well as with MAMC (r = -0.28 P = 0.028), %fat (r= -0.27, P = 0.042) and nPCR (r = -0.29 P = 0.027). Multiple regression analysi s showed that the relationship of subjective global assessment (as a d ependent variable) with objective measurements (covariates) was strong er (multiple r = 0.77) than the relationship found with univariate ana lysis. This finding indicates that subjective global assessment gives a well-based and balanced estimation of nutritional status. Our data s how that subjective global assessment is a clinically adequate method for assessing nutritional status in dialysis patients. Being an inexpe nsive method of well-proven reliability, subjective global assessment can be recommended for a more frequent assessment of nutritional statu s in dialysis patients.