title: Subjective global assessment of nutrition a useful diagnostic tool for nurses?
abstract: Malnutrition in maintenance haemodialysis (HD) patients is closely related with morbidity and mortality in this population.
  
  
  OBJECTIVE
  To evaluate feasibility, performance and information given by SGA (subjective global assessment), a semi-quantitative method of nutritional evaluation (based on a medical questionnaire and a simple clinical examination) carried out by a group of 12 nurses.
  
  
  METHODS
  In March 1999, a feasibility study was organised to evaluate 9 patients during HD. Since July 1999, a nutritional evaluation of all the patients meeting the required parameters (e.g. duration of HD > 6 months, day sessions) has been set up every 4 months.
  
  
  RESULTS
  In March 1999, preliminary results demonstrated an average learning time per SGA of 15'. In July 1999, 32 patients were evaluated, albuminemia (micromol/l) and pre-albuminemia (g/l) were analysed according to the SGA classification (A = good nutrition, B= light to moderate malnutrition, C= severe malnutrition). The albuminemia and the prealbuminemia of patients A (respectively 541+/-45 and 0.37+/-0.10) were higher than those of patients B (482+/-41 and 0.31+/-0.01), and those of patients C (381+/-54 and 0.19+/-0.1), by variance analysis (p < 0.0001). The information drawn from the SGA reveal a severe malnutrition, a light to moderate malnutrition, and good nutrition in respectively 13%, 63% and 25% of the patients, and a noticeable muscular atrophy (moderate to severe) in 43% of cases. Anorexia and major gastro-intestinal symptom (nausea, vomiting, and diarrhoea) are found in 14% of cases.
  
  
  CONCLUSIONS
  Beside traditional methods of screening and evaluation of malnutrition in HD patients, the use of SGA by a nursing team uncovers useful information on nutritional status of patients, especially in areas lacking facilities such as a laboratory, dietetic department or permanent presence of doctors.
authors.affiliation: Haemodialysis unit, Hôspital Saint-André, Bordeaux, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Julien
authors.forename: C
authors.initials: C
authors.lastname: Combe
authors.forename: C
authors.initials: C
authors.lastname: Lasseur
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009733:Nursing Diagnosis; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000451:nursing*; D011237:Predictive Value of Tests; D011379:Prognosis; D006435:Renal Dialysis; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires