Evaluation of nutrition assessment tools compared with body cell mass for the assessment of malnutrition in chronic kidney disease.
OBJECTIVE
We compared the subjective global assessment (SGA) and a range of SGA-based assessment tools with body cell mass (BCM) in patients with stage IV and V predialysis chronic kidney disease (CKD).


METHODS
This was a cross-sectional, observational study.


METHODS
The study took place at a public tertiary hospital predialysis outpatient clinic.


METHODS
A total of 56 consecutive consenting patients with CKD (61% were male; age [mean +/- standard deviation] 70.2 +/- 11.6 years; glomerular filtration rate 22.2 +/- 6.8 mL/min).


METHODS
Nutrition status was the main outcome measure.


RESULTS
In this population, the prevalence of malnutrition was 19.6% (n = 11, SGA B; no C ratings). Malnutrition was associated with lower BCM (mean BCM, 26.3 vs. 33.4 kg, P = .007, measured by total body potassium), body weight (64.8 vs. 76.1 kg, P = .042), body mass index (23.7 vs. 27.6 kg/m(2), P = .015), and greater weight loss over the previous 6 months (-6.2 vs. -0.1 kg, P = .004). BCM had a weak relationship with 7-point SGA (P = .267), malnutrition inflammation score (r = -0.27 P = .063), and patient-generated SGA (r = -0.27 P = .060). There was no association for either measure of nutrition status (SGA or BCM) with albumin, glomerular filtration rate, or C-reactive protein.


CONCLUSIONS
SGA in its original form most accurately delineated malnutrition by depleted BCM and is the most appropriate tool for cross-sectional assessment of nutrition status in patients with predialysis CKD.
Campbell
Katrina L
KL
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. kl.campbell@qut.edu.au <kl.campbell@qut.edu.au>
Ash
Susan
S
Bauer
Judith D
JD
Davies
Peter S W
PS
D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011188:Potassium / Q000032:analysis
D011188:Potassium