Evaluation of Nutrition Assessment Tools Compared With Body Cell Mass for the Assessment of Malnutrition in Chronic Kidney Disease

Campbell, Katrina L.; Ash, Susan; Bauer, Judith D.; Davies, Peter S.W.

doi:10.1053/j.jrn.2006.12.005

« Previous Next »Journal of Renal Nutrition
Volume 17, Issue 3 , Pages 189-195, May 2007

Evaluation of Nutrition Assessment Tools Compared With Body Cell Mass for the Assessment of Malnutrition in Chronic Kidney Disease

Katrina L. Campbell, B Hlth Sci (Hons)
- 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.
- 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.
Susan Ash, BSc, Dip Nut Diet, MHealth Planning, PhD
- 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.
Judith D. Bauer, BSc, Grad Dip Nut & Diet, M Hlth Sc, PhD
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
- Wesley Research Institute, The Wesley Hospital, Brisbane, Australia.
Peter S.W. Davies, BSc (Hons), M Phil, PhD
- Children’s Nutrition Research Centre, Royal Children’s Hospital, University of Queensland, Brisbane, Australia.

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.