Enia G, Sicuso C, Alati G, Zoccali C
Division of Nephrology and CNR, Reggio Calabria, Italy.
Nephrol Dial Transplant. 1993;8(10):1094-8.
Malnutrition is a major negative prognostic factor in dialysis patients. Simple and reliable estimations of nutritional status may therefore prove of particular value in the follow-up of these patients. To validate subjective global assessment (SGA) in dialysis patients we compared subjective global assessment with objective measurements (anthropometry, bioelectrical impedance, biochemical measurements) in 59 chronic uraemic patients treated by haemodialysis (n = 36) or CAPD (n = 23). Subjective global assessment was performed by an observer unaware of the results of objective measurements and was related to serum albumin (r = -0.51, P < 0.001) and bioelectric impedance phase angle (r = -0.58, P < 0.001) as well as with MAMC (r = -0.28 P = 0.028), %fat (r = -0.27, P = 0.042) and nPCR (r = -0.29 P = 0.027). Multiple regression analysis showed that the relationship of subjective global assessment (as a dependent variable) with objective measurements (covariates) was stronger (multiple r = 0.77) than the relationship found with univariate analysis. This finding indicates that subjective global assessment gives a well-based and balanced estimation of nutritional status. Our data show that subjective global assessment is a clinically adequate method for assessing nutritional status in dialysis patients. Being an inexpensive method of well-proven reliability, subjective global assessment can be recommended for a more frequent assessment of nutritional status in dialysis patients.
营养不良是透析患者的一个主要不良预后因素。因此，简单可靠的营养状况评估方法可能对这些患者的随访具有特殊价值。为了验证主观全面评定法（SGA）在透析患者中的有效性，我们对59例接受血液透析（n = 36）或持续性非卧床腹膜透析（CAPD，n = 23）治疗的慢性尿毒症患者，将主观全面评定法与客观测量指标（人体测量、生物电阻抗、生化检测）进行了比较。主观全面评定法由一名不了解客观测量结果的观察者进行，结果显示其与血清白蛋白（r = -0.51，P < 0.001）、生物电阻抗相角（r = -0.58，P < 0.001）以及上臂中部肌肉周长（MAMC，r = -0.28，P = 0.028）、体脂百分比（%fat，r = -0.27，P = 0.042）和标准化蛋白分解代谢率（nPCR，r = -0.29，P = 0.027）相关。多元回归分析表明，主观全面评定法（作为因变量）与客观测量指标（协变量）之间的关系（复相关系数r = 0.77）比单变量分析中发现的关系更强。这一发现表明，主观全面评定法能对营养状况进行有充分依据且平衡的评估。我们的数据表明，主观全面评定法是评估透析患者营养状况的一种临床适用方法。作为一种可靠性已得到充分验证且成本低廉的方法，主观全面评定法可推荐用于更频繁地评估透析患者的营养状况。
