Original research
Assessment of nutritional status in hemodialysis patients using patient-generated subjective global assessment

https://doi.org/10.1053/j.jrn.2004.10.005Get rights and content

Objective

To evaluate the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in hemodialysis patients.

Design

A cross-sectional observational study assessing the nutritional status of hemodialysis patients.

Setting

Private tertiary Australian hospital.

Subjects

Sixty patients, ages 63.9 ± 16.2 years.

Intervention

Scored PG-SGA questionnaire, comparison of PG-SGA score ≥9 with subjective global assessment (SGA), albumin, corrected arm muscle area, and triceps skinfold.

Results

According to SGA, 80% of patients were well nourished and 20% of patients were malnourished. Patients classified as well nourished (SGA-A) attained a significantly lower median PG-SGA score compared with those rated as moderately malnourished or at risk of malnutrition (SGA-B). A PG-SGA score ≥9 had a sensitivity of 83% and a specificity of 92% at predicting SGA classification. There were significant correlations between the PG-SGA score and serum albumin, PG-SGA score, and percentage weight loss over the past 6 months. There was no association between PG-SGA score and body mass index or anthropometric measurements.

Conclusion

The scored PG-SGA is an easy-to-use nutrition assessment tool that allows quick identification of malnutrition in hemodialysis patients.

Section snippets

Methods

The nutritional status of 60 patients (age 63.9 ± 16.2 years; 32 men, 28 women; BMI 25 ± 6) was assessed during 2 audits of the HD unit. Over a 1-week period in 2001 and 2003, all patients attending the dialysis unit for chronic renal conditions were approached to participate in the assessment as part of routine practice. Data from 2003 only includes 27 patients not attending the unit in 2001, (n = 33, 2001; n = 27, 2003). The Multidisciplinary Ethics Committee of the hospital approved the

Statistical analysis

Statistical analysis was carried out using SPSS Version 11, 2001 (SPSS Inc, Chicago, IL). Because the dependent variable PG-SGA score was not normally distributed, the nonparametric Mann-Whitney test was used to compare median PG-SGA scores for each SGA classification. A contingency table was used to determine the sensitivity, specificity, and predictive value of a PG-SGA score of ≥9 compared with SGA global ratings. Reliability analysis was used to determine the extent to which items in the

The scored PG-SGA as a nutrition assessment tool

According to SGA classification, 80% of patients were well nourished and 20% were moderately or suspected of being malnourished. There were no cases of severe malnutrition. The ability of a PG-SGA score ≥9 to predict SGA classification is shown in Table 1. Seventy-three percent (44) of 60 patients were correctly classified by the score as being well nourished (true negatives), and 17% (10) of patients were correctly classified as being malnourished (true positives). Three percent (2) of

Discussion

The goal of this study was to evaluate the scored PG-SGA as a nutrition assessment tool in HD patients. According to SGA classification, 80% of patients were well nourished, 20% were moderately malnourished or at risk of malnutrition, and no patients were assessed as severely malnourished. This relatively low prevalence of malnutrition partially may be explained by the socioeconomic status of the patients, which was likely to be high given that they were able to finance treatment in a private

References (32)

Cited by (0)

View full text