Assessment and follow-up of nutritional status in hemodialysis patients

Malnutrition is common among hemodialysis patients and is associated with increased risk of morbidity and mortality. Early recognition and treatment of malnutrition is essential to improve the outcome of these patients. Nutritional status may be assessed by several clinical markers including dietary records, anthropometric measurements and subjective global assessment. Among biochemical parameters, albumin is the most commonly used and prealbumin the most useful. Protein catabolic rate reflects dietary protein intake. Body composition analysis by bioelectrical. impedance analysis or better by dual energy X-ray absorptiometry offers a reasonable estimation of body compartments such as total body water, fat mass and lean body mass. Periodic assessment of nutritional status must take into account the l imitations of each criteria used. (C) 2009 Elsevier Masson SAS et Association Societe de Nephrologie. Tous droits reserves.