Evaluation of Nutrition Assessment Tools Compared With Body Cell Mass for the Assessment of Malnutrition in Chronic Kidney Disease
Objective
We compared the subjective global assessment (SGA) and a range of SGA-based assessment tools with body cell mass (BCM) in patients with stage IV and V predialysis chronic kidney disease (CKD).
Study Design
This was a cross-sectional, observational study.
Setting
The study took place at a public tertiary hospital predialysis outpatient clinic.
Patients
A total of 56 consecutive consenting patients with CKD (61% were male; age [mean ± standard deviation] 70.2 ± 11.6 years; glomerular filtration rate 22.2 ± 6.8 mL/min).
Main Outcome Measure
Nutrition status was the main outcome measure.
Results
In this population, the prevalence of malnutrition was 19.6% (n = 11, SGA B; no C ratings). Malnutrition was associated with lower BCM (mean BCM, 26.3 vs. 33.4 kg, P = .007, measured by total body potassium), body weight (64.8 vs. 76.1 kg, P = .042), body mass index (23.7 vs. 27.6 kg/m2, P = .015), and greater weight loss over the previous 6 months (−6.2 vs. −0.1 kg, P = .004). BCM had a weak relationship with 7-point SGA (P = .267), malnutrition inflammation score (r = −0.27 P = .063), and patient-generated SGA (r = −0.27 P = .060). There was no association for either measure of nutrition status (SGA or BCM) with albumin, glomerular filtration rate, or C-reactive protein.
Conclusion
SGA in its original form most accurately delineated malnutrition by depleted BCM and is the most appropriate tool for cross-sectional assessment of nutrition status in patients with predialysis CKD.
⁎Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
†Department of Nutrition and Dietetics, Royal Brisbane and Women’s Hospital, Brisbane, Australia.
‡Wesley Research Institute, The Wesley Hospital, Brisbane, Australia.
§Children’s Nutrition Research Centre, Royal Children’s Hospital, University of Queensland, Brisbane, Australia.
Address reprint requests to Katrina L. Campbell, B Hlth Sci (Hons), Institute of Health and Biomedical Innovation, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia.
ABSTRACT