Comparing Methods for Assessment of Nutritional Status in Hemodialysis Patients: A Review

Abstract

The global number of hemodialysis patients has an increasing trend and is still one of the most important protein-energy malnutrition with high morbidity and mortality. Therefore, proper assessment of nutritional status of these patients seems essential. In this review, we compared several methods of nutritional assessment in these patients. It was shown that subjective methods such as subjective global assessment (SGA) were widely used with good validity and accuracy. Malnutrition-inflammation score (MIS) as another common method evaluated the patient’s physical and mental condition based on the level of inflammation. Mini Nutrition Assessment (MNA) as another method assessed the nutritional status of elderly hemodialysis patients, but the interpretation of the results is based on the specific conditions of renal patients. Assessment of body composition by bioelectrical impedance has been one of the most accurate nutritional assessment methods predicting the risk of malnutrition based on the amount of lean tissue loss in the body, but it requires advanced equipment and high financial cost. There are other assessment methods, such as normalized protein catabolic ratio (nPCR) that tries to determine malnutrition based on the amount of dietary protein intake, which is nearly the metabolized protein in the body. Using them alone or in combination with other methods was demonstrated to be beneficial.