title: [Malnutrition in chronic kidney failure: what is the best diagnostic method to assess?].
abstract: BACKGROUND
  Protein-energy malnutrition, systemic inflammation, and metabolic disorders are frequent among patients with chronic kidney failure undergoing dialysis, contributing to their morbidity and mortality.
  
  
  METHODS
  In the present study, the prevalence of malnutrition in chronic renal patients undergoing hemodialysis in one single center in the Northeastern region of Brazil was assessed according to the following: three different methods of subjective global assessment (SGA); body mass index (BMI); percent of standard body weight; adequacy to the 50th percentile of triceps skinfold (TSF) and arm muscle circumference (AMC) thicknesses; pre-dialysis albumin; phase angle; and percentage of body cell mass (%BCM). Agreement of the nutritional status diagnosis performed through SGA with anthropometric, biochemical, and bioelectrical impedance measures was assessed.
  
  
  RESULTS
  The study assessed 58 patients [females, 30 (51.7%); mean age = 49 years]. The prevalence of malnutrition according to the different methods ranged from 12.1% to 94.8%. Conventional SGA showed a moderate agreement with patient-generated SGA (PG-SGA), BMI (cutoff point, 22.0 kg/m²), and AMC; a fair agreement with BMI (cutoff point, 18.5 kg/m²), percent of standard body weight, AC, and phase angle; and a poor agreement with SGA adapted to the renal patient, TSF, and %BCM.
  
  
  CONCLUSIONS
  The nutritional assessment methods commonly used in clinical practice are subject to restrictions when applied to the dialysis population, considering the different percentages obtained with the different methods. Longitudinal, prospective studies on the association of nutritional markers with adverse events, such as hospitalization and mortality, should be carried out to clarify remaining issues.
authors: Departamento de Nutrição, Universidade Estadual do Ceará.
authors: Claudia Maria Costa de
authors: CM
authors: Oliveira
authors: Marcos
authors: M
authors: Kubrusly
authors: Rosa Salani
authors: RS
authors: Mota
authors: Carlos Antonio Bruno da
authors: CA
authors: Silva
authors: Valzimeire N
authors: VN
authors: Oliveira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult