Subjective global assessment of the patients of chronic kidney disease undergoing dialysis

Abstract

Background: Malnutrition is an important risk factor in patients with chronic kidney disease and in those undergoing maintenance dialysis. Subjective global assessment is a reliable method to evaluate malnutrition in these patients. This study aims to evaluate malnutrition in patients of chronic kidney disease using subjective global assesment score.Methods: A cross sectional study was conducted at SRN Hospital, Allahabad, Uttar Pradesh, India on patients attending Nephrology Unit from July 2014 to May 2015.The nutritional status of 100 patients was evaluated using dietary recall, anthropometry, biochemical parameter and subjective global assessment. There were 67 males and 23 females. Their mean age was 46.8 years. Subjective global assessment was done using 7 variables derived from medical history and physical examination. Each variable was scored from 1-5 depending on the severity. The subjective global assessment score was correlated with the standard methods.Results: Out of 100 patients 29% were mildly malnourished, 64% were moderately malnourished and 7% were severely malnourished. The age, triceps thickness, serum urea and cholesterol were correlated with the malnutrition score (r value 0.2, -0.3, 0.2, 0.4 respectively and p-value 0.3, 0.002, 0.007, 0.001 respectively). It was found that the serum albumin (r value -0.21, p-value 0.42) level did not correlate well with the subjective global assessment.Conclusions: The subjective global assessment can be used reliably to assess the malnutrition in the patients of chronic kidney disease and hence useful in prognostication of disease and is a convenient bedside tool, operable even with  paramedics.