title: Assessment of methods to identify protein-energy wasting in patients on hemodialysis.
abstract: BACKGROUND
  The method capable of best identifying protein-energy wasting (PEW) in hemodialysis (HD) patients is controversial. Thus, we assessed the nutritional status of HD patients by use of different methods and verified which one identified the highest number of patients with PEW.
  
  
  METHODS
  The study assessed the nutritional status of 15 HD patients (age: 52.7 ± 10.1 years; males: 33.3%) by use of anthropometric measurements, subjective global assessment (SGA), serum albumin, and dietary intake (24-hour food recall). Body fat was assessed by use of anthropometry. The International Society of Renal Nutrition and Metabolism (ISRNM) criteria were used to diagnose PEW.
  
  
  RESULTS
  The body mass index (24.2 ± 4.4 kg/m²) and the percentage of standard value for mid-arm muscle circumference were within the normal limits (102.6 ± 13%). Nevertheless, the percentage of standard value for triceps skinfold was below the normal limits (females, 75.3 ± 40.4%; and males, 73.5 ± 20.6%), although a high body fat percentage was observed (females, 34.5 ± 7.3%; males, 23.6 ± 4.2%). When assessing the nutritional status by use of SGA, most patients (80%, n = 12) were malnourished, and SGA was the method that identified the highest number of patients with PEW. By using the ISRNM criteria, PEW was diagnosed in only two patients.
  
  
  CONCLUSIONS
  All patients were diagnosed with PEW by use of one of the methods studied. The SGA was the method that, in isolation, could detect the greatest number of patients with PEW.
authors.affiliation: Universidade do Estado do Rio de Janeiro.
authors.forename: Patrícia Marçal
authors.initials: PM
authors.lastname: Vegine
authors.forename: Ana Carolina Packness
authors.initials: AC
authors.lastname: Fernandes
authors.forename: Márcia Regina Simas Gonçalves
authors.initials: MR
authors.lastname: Torres
authors.forename: Maria Inês Barreto
authors.initials: MI
authors.lastname: Silva
authors.forename: Carla Maria
authors.initials: CM
authors.lastname: Avesani
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000175:diagnosis* / Q000209:etiology; D006435:Renal Dialysis; D019282:Wasting Syndrome / Q000175:diagnosis* / Q000209:etiology