Laboratory tests and nutritional assessment. Protein-energy status

1. There is no one definitive laboratory test, group of tests, or indices that are satisfactory for the assessment of protein-calorie status. 2. Clinical evaluation remains the simplest, most widely available, most reproducible, and wisest method. It is satisfactory for the majority of clinical situations. 3. The laboratory should be used selectively and to complement clinical evaluation. Routine testing must be relegated to research protocols. 4. Always include some assessment of inflammation (for example, C-reactive protein, erythrosedimentation rate [ESR]), because its presence affects the interpretation of all the other tests. 5. The pathophysiologic effects of the underlying disease, especially in hospitalized patients, will affect the interpretation of every one of the laboratory tests. 6. Nutritional status often impacts more on the interpretation of commonly performed laboratory tests than laboratory tests impact on the assessment of nutrition.