How is malnutrition diagnosed in chronic kidney disease

How is malnutrition diagnosed in patients with chronic kidney disease (CKD)?

How is nutritional status assessed?

• There is no single way to assess nutritional status, which is a consequence of a complex interplay of nutrient intake and catabolism, with significant effect modification by comorbid conditions, especially inflammatory conditions.

• PEW can be diagnosed in clinical practice using five different criteria:

• Biochemical measures (serum albumin, prealbumin, transferrin, and cholesterol)

• Measures of body mass (body mass index [BMI], unintentional weight loss, and total body fat)

• Measures of muscle mass (total muscle mass, mid-arm muscle circumference, and creatinine appearance)

• Measures of dietary intake (dietary protein and energy intake)

• Integrative nutritional scoring systems (subjective global assessment of nutrition and malnutrition-inflammation score)

• In addition to these readily available measures of PEW, a series of other markers have also been proposed, which could have applicability as research tools; these include measures of appetite, food intake and energy expenditure, other measures of body mass and composition (such as dual energy x-ray absorptiometry [DEXA], bioimpedance, near-infrared interactance, or computed tomography/magnetic resonance imaging of muscle mass) and laboratory measures (such as growth hormone levels, C-reactive protein, interleukin-1, interleukin-6, tumor necrosis factor alpha, serum amyloid-A or peripheral blood cell counts


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