SGA scores have poor correlation with serum albumin in obese hemodialysis patients: a secondary analysis.
OBJECTIVE
The objective of this study was to determine the relationship between serum albumin and the Subjective Global Assessment (SGA) in a sample of obese hemodialysis (HD) patients.


METHODS
Study subjects (N = 253) included patients who were categorized into well-nourished (68%, SGA score 6-7) and malnourished (score 1-5) groups, and, on the basis of the body mass index (BMI), into obese (BMI > 30 kg/m(2); 35%) and nonobese (BMI < 30 kg/m(2)). The mean baseline data (±standard deviation) were as follows: age, 63.5 ± 14.3 years; BMI, 29 ± 8 kg/m(2); and serum albumin, 3.8 ± 0.4 mg/dL (bromocresol green). The secondary analysis of data from the SGA Validation Project and Nutrition Algorithm Preliminary Report determined the relationship between the 7-point SGA and serum albumin concentrations in a sample of obese HD patients. Data were analyzed at Case Western Reserve University from a total of 253 HD patients.


METHODS
The SGA scores in the BMI groups were compared with serum albumin as an objective measure of nutrition and inflammation risk.


RESULTS
By using analysis of variance, the obese and nonobese populations showed statistically significant differences in SGA scores (obese: P < .3468, nonobese: P < .0080) and serum albumin values (obese, P < .0943; nonobese, P < .0183) between well-nourished and malnourished groups. A multivariable nominal logistic fit was used to predict SGA group with age and gender as covariates. Serum albumin values (P < .0057) and BMI values greater than 30 (P < .0090) predicted SGA group.


CONCLUSIONS
The secondary analysis showed that SGA does not correlate well with serum albumin; thus, it may not be a valid nutrition assessment tool among obese HD patients.
Department of Nutrition, Case Western Reserve University, Cleveland, OH.
Eric D
ED
Erb
Academy of Nutrition and Dietetics, Chicago, IL. Electronic address: rhand@eatright.org.
Rosa K
RK
Hand
Academy of Nutrition and Dietetics, Chicago, IL.
Alison L
AL
Steiber
D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000150:complications; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D009765:Obesity / Q000097:blood* / Q000150:complications; D006435:Renal Dialysis; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000378:metabolism*
D012709:Serum Albumin