title: Comparing Tests Assessing Protein-Energy Wasting: Relation With Quality of Life.
abstract: OBJECTIVE
  Protein-energy wasting (PEW), a state of decreased bodily protein and energy fuels, is highly prevalent among hemodialysis patients. The best method to determine PEW, however, remains debated. As an independent, negative association between PEW and quality of life (QOL) has been demonstrated, establishing which nutrition-related test correlates best with QOL may help to identify how PEW should preferably be assessed.
  
  
  METHODS
  Data were used from CONTRAST, a cohort of end-stage kidney disease patients. At baseline, Subjective Global Assessment (SGA), Malnutrition Inflammation Score (MIS), Geriatric Nutritional Risk Index, composite score on protein-energy nutritional status, normalized protein nitrogen appearance, body mass index, serum albumin, and serum creatinine were determined. QOL was assessed by the Kidney Disease Quality of Life Short Form 1.3. The present study reports on 2 general and 11 kidney disease-specific QOL scores. Spearman's rho (ρ) was calculated to determine correlations between nutrition-related tests and QOL domains. Twelve months after randomization, a sensitivity analysis was performed to test the robustness of the results.
  
  
  RESULTS
  Of 714 patients, 489 representative subjects were available for analysis. All tests correlated with the Physical Component Score, except body mass index. Only SGA and MIS correlated significantly with the Mental Component Score. SGA correlated significantly with 10 of 11 kidney disease-specific QOL domains. The MIS not only correlated significantly with all (11) kidney disease-specific QOL domains but also with higher correlation coefficients.
  
  
  CONCLUSIONS
  Of the 8 investigated nutrition-related tests, only MIS correlates with all QOL domains (13 of 13) with the strongest associations.
authors.affiliation: Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands; Institute for Cardiovascular Research VU University Medical Center (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands. Electronic address: c.deroijvanzuijdewijn@vumc.nl.
authors.forename: Camiel L M
authors.initials: CL
authors.lastname: de Roij van Zuijdewijn
authors.affiliation: Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands; Institute for Cardiovascular Research VU University Medical Center (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Muriel P C
authors.initials: MP
authors.lastname: Grooteman
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.affiliation: Department of Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Blankestijn
authors.affiliation: Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands.
authors.forename: Marinus A
authors.initials: MA
authors.lastname: van den Dorpel
authors.affiliation: Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands; Institute for Cardiovascular Research VU University Medical Center (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Menso J
authors.initials: MJ
authors.lastname: Nubé
authors.affiliation: Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands; Institute for Cardiovascular Research VU University Medical Center (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Piet M
authors.initials: PM
authors.lastname: ter Wee
mesh_terms: D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000175:diagnosis*; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000378:metabolism; D019282:Wasting Syndrome / Q000097:blood / Q000175:diagnosis*
chemical_list: D012709:Serum Albumin; D003404:Creatinine