title: Prevalence of protein-energy wasting and its various types in Iranian hemodialysis patients: a new classification.
abstract: BACKGROUND
  This study was designed to determine the prevalence of protein-energy wasting (PEW) and its various types in hemodialysis (HD) patients in Tehran, Iran.
  
  
  METHODS
  For this cross-sectional study, 291 HD patients were randomly selected. The nutritional status of the patients was determined by subjective global assessment (SGA) and their dietary intakes were assessed using a 4-day dietary recall. In addition, serum high-sensitive C-reactive protein (hs-CRP) was measured.
  
  
  RESULTS
  The prevalence of mild-to-moderate and severe PEW based on SGA was 60.5% and 1% in Tehran HD patients, respectively. The prevalence of various types of PEW in HD patients was 20.5% type I (inadequate energy or protein intake without inflammation), 65.5% type IIa (inadequate energy or protein intake with inflammation), and 14% type IIb (adequate energy and protein intake with inflammation). Of the total HD patients with no PEW based on SGA, about 3.5% had type 0 normal nutritional status (adequate energy and protein intake without inflammation), 34% had type I normal nutritional status (inadequate energy or protein intake without inflammation), 55.5% had type IIa normal nutritional status (inadequate energy or protein intake with inflammation), and 7% had type IIb normal nutritional status (adequate energy and protein intake with inflammation).
  
  
  CONCLUSIONS
  PEW in Tehran HD patients is considerably prevalent and PEW type IIa is the most common type. In addition, HD patients with no PEW based on SGA should also be paid attention because they may be in the early stages of inadequate intake of energy and/or protein and inflammation.
authors.affiliation: Department of Clinical Nutrition & Dietetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran. hadtabibi@yahoo.com
authors.forename: Hadi
authors.initials: H
authors.lastname: Tabibi
authors.forename: Atefeh
authors.initials: A
authors.lastname: As'habi
authors.forename: Behnaz Nozary
authors.initials: BN
authors.lastname: Heshmati
authors.forename: Mitra
authors.initials: M
authors.lastname: Mahdavi-Mazdeh
authors.forename: Mehdi
authors.initials: M
authors.lastname: Hedayati
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011502:Protein-Energy Malnutrition / Q000145:classification* / Q000453:epidemiology*; D006435:Renal Dialysis; D019282:Wasting Syndrome / Q000145:classification* / Q000453:epidemiology*; D055815:Young Adult