Malnutrition in Renal Failure: Pleiotropic Diagnostic Approaches, Inefficient Therapy and Bad Prognosis

Malnutrition is very common and connected with high morbidity and mortality of patients on chronic hemodialysis. A cross-sectional, longitudinal study was performed in maintenance dialysis patients intending to determine association between modified Subjective Global Assessment (SGA), serum albumin and mortality. Cross-sectional study of phase angle (PhA) values and other indices of bioelectrical impedance body analysis (BIA) were correlated to biochemical data and malnutrition-inflammation score (MIS). In the group of 184 hemodialysis patients, we found 39 malnourished patients. In overall 50 months of observation, 25 out of 39 malnourished patients died. All patients with albumin values less than 30 g/L died. The group with albumin values greater than 30 g/L (N = 26) showed higher survival rate, 12 patients died in the observed period. SGA values higher than 21 and albumin values lower than 30 g/L are useful predictors of death in malnourished dialysis patients. PhA is an independent predictor of malnutrition with promising potential to replace other diagnostic tools.