title: What is the impact of nutritional status on health-related quality of life in hemodialysis patients?
abstract: OBJECTIVE
  To develop a nutrition-specific quality of life (NSQOL) questionnaire that combines the Appetite and Diet Assessment Tool and the Food Enjoyment in Dialysis tool, and to measure the association between nutritional status and both the NSQOL and the generic health-related quality of life (HRQOL) in hemodialysis patients.
  
  
  METHODS
  Cross-sectional study of 89 hemodialysis patients. Nutritional status was measured by subjective global assessment and biochemical indices, including serum albumin concentration. Adequacy of dialysis was also measured. To determine the correlation between quality of life and nutritional status, both the NSQOL and the HRQOL instruments were used.
  
  
  RESULTS
  The mean NSQOL score for the entire cohort was 8.9 ± 4.5. The NSQOL was positively correlated with the mental component score (r = 0.52, P < .001) and the physical component score (PCS) (r = 0.29, P < .05) of the HRQOL questionnaire. There was no difference in the NSQOL score between the moderately malnourished and the mildly malnourished to well-nourished patients. The mean PCS was significantly lower in the moderately malnourished group as compared with the mildly malnourished and well-nourished groups (33.4 ± 10.7 vs. 38.9 ± 10.2, P < .05); however, there was no difference in the mean mental component score between the groups. Nutritional status, as assessed by subjective global assessment, was positively correlated with the PCS (r = 0.33, P < .05) and serum albumin concentration (r = 0.35, P = .01).
  
  
  CONCLUSIONS
  We developed an NSQOL questionnaire by combining the Appetite and Diet Assessment Tool and the Food Enjoyment in Dialysis tool. The NSQOL questionnaire is a rapid self-administered tool that can be used to assess appetite-related quality of life in patients receiving maintenance hemodialysis. This instrument correlated well with HRQOL indices in this cohort of hemodialysis patients.
authors.affiliation: Harvard Vanguard Medical Associate, Boston, Massachusetts. Electronic address: hhan1@comast.net.
authors.forename: Haewook
authors.initials: H
authors.lastname: Han
authors.affiliation: C.W. Post Campus of Long Island University, Brookville, New York.
authors.forename: Jerrilynn D
authors.initials: JD
authors.lastname: Burrowes
authors.affiliation: Tufts University Friedman School of Nutrition, Boston, MA.
authors.forename: Robert
authors.initials: R
authors.lastname: Houser
authors.affiliation: Tufts University Friedman School of Nutrition, Boston, MA.
authors.forename: Mei-Chun
authors.initials: MC
authors.lastname: Chung
authors.affiliation: Tufts University Friedman School of Nutrition, Boston, MA.
authors.forename: Johanna T
authors.initials: JT
authors.lastname: Dwyer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001066:Appetite; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011788:Quality of Life; D006435:Renal Dialysis; D012709:Serum Albumin; D011795:Surveys and Questionnaires
chemical_list: D012709:Serum Albumin