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Nutritional Screening in Patients on Hemodialysis: Is Subjective Global Assessment an Appropriate Tool?

Lookup NU author(s): Professor Tim Goodship


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Objective: Malnutrition is common in patients with chronic renal failure and should be screened for systematically. Subjective global assessment (SGA) is frequently used, but it is time-consuming. The aim of this study was to assess the sensitivity of SGA as a screening tool for malnutrition compared with the measurement of body mass index (BMI) and serum albumin combined with a history of unintentional weight loss. Design: This was a cross-sectional study. Setting: The study was undertaken in two hospital hemodialysis units. Patients and Intervention: A total of 141 patients on hemodialysis were studied. Nutritional assessment was undertaken with a seven-point SGA, measurement of height, weight and serum albumin, and a record of unintentional weight loss. Outcomes: Patients were considered to be at risk of malnutrition if any of the following three criteria were met: a serum albumin less than 35 g/L, a BMI less than 18.5, and unintentional weight loss of edema free weight greater than 10% in the past 6 months. A diagnosis of malnutrition was made if the SGA score was between 1 and 5. Results: A total of 41 patients had either a serum albumin less than 35 g/L or a BMI less than 18.5 or unintentional weight loss of edema free weight of more than 10% in the past 6 months. Of these 41 patients, 29 had a serum albumin less than 35 g/L, 9 had a BMI less than 18.5, and 15 had unintentional loss of edema free weight greater than 10% in the past 6 months. Thirteen patients were judged by SGA to be mild to moderately malnourished. All 13 were identified by serum albumin, BMI, or weight loss. Conclusions: In this study, measurement of SGA did not diagnose malnutrition in any patients in whom this had not already been potentially identified by measurement of serum albumin, BMI, and a history of weight loss. SGA did not therefore increase the sensitivity of nutritional screening in this cohort. © 2007 National Kidney Foundation, Inc.

Publication metadata

Author(s): Gurreebun F, Hartley GH, Brown AL, Ward MC, Goodship THJ

Publication type: Article

Publication status: Published

Journal: Journal of Renal Nutrition

Year: 2007

Volume: 17

Issue: 2

Pages: 114-117

Print publication date: 01/03/2007

ISSN (print): 1051-2276

ISSN (electronic): 1532-8503

Publisher: WB Saunders Co.


DOI: 10.1053/j.jrn.2006.12.008

PubMed id: 17321950


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