title: Reliability of the 7-point subjective global assessment scale in assessing nutritional status of dialysis patients.
abstract: Subjective global assessment (SGA) is a method to score nutritional status in a standardized way. The original 3-point scale has been replaced by a 7-point scale. The reliability of the latter scale has never been tested. We therefore assessed inter-observer and intra-observer reliability. Furthermore, we examined the relationship of SGA with other objective nutritional parameters. In 13 hemodialysis and 9 peritoneal dialysis patients, two nurses assessed SGA. They re-examined the same patients two weeks later. Anthropometric measurements and blood samples were taken at the first assessment. According to SGA, 2 patients (9%) were classified as severely malnourished, 6 (27%) as mildly malnourished, and 14 (64%) as well nourished. The 7-point SGA scale showed fair inter-observer reliability [intraclass correlation (ICC) = 0.72] and good intra-observer reliability (ICC = 0.88). A strong correlation was present between the 7-point SGA scale and body mass index (BMI) (r = 0.79, p < 0.001), % fat (r = 0.77, p < 0.001), and mid arm circumference (r = 0.71, p < 0.001). Lower correlations were found with mid arm muscle circumference and serum albumin. With respect to biochemical markers, the strongest relationship was found with prealbumin (r = 0.60, p = 0.004). We conclude that the 7-point SGA scale is a valid and reliable tool to assess nutritional status among end-stage renal disease patients. We suggest that one observer or a select group of observers perform the assessments to gain maximum benefit from the reliability of the SGA instrument.
authors.affiliation: Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Visser
authors.forename: F W
authors.initials: FW
authors.lastname: Dekker
authors.forename: E W
authors.initials: EW
authors.lastname: Boeschoten
authors.forename: P
authors.initials: P
authors.lastname: Stevens
authors.forename: R T
authors.initials: RT
authors.lastname: Krediet
mesh_terms: D000886:Anthropometry; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D015588:Observer Variation; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis
chemical_list: D012709:Serum Albumin