How common is malnutrition in ESRD? New approaches to diagnosis of malnutrition.

Malnutrition is associated with increased mortality in the dialysis population. However, the true prevalence of malnutrition is not known due to the lack of simple diagnostic strategies for assessing nutritional status. Internationally recommended diagnostic algorithms mainly include the one-time assessment of nutritional indices and comparison to normal reference values. However, these indices do not take into account the dynamics of malnutrition which is associated with a progressive change in body composition and loss in muscle mass. Longitudinal assessment of changes in body composition may be necessary to improve timing and accuracy of the diagnosis of undernutrition. Whole-body as well as segmental multifrequency bioimpedance spectroscopy have been shown to yield good estimates of total body or segmental (limb) muscle mass. Bioimpedance spectroscopy is a relatively inexpensive, non-invasive, painless method requiring only minimal operator training, which in the near future may prove useful for nutritional management of ESRD patients.