Nutritional Assessment: Subjective Global Assessment

Subjective Global Assessment (SGA)

SGA score is currently, commonly used as a valid and reliable nutritional status indicator in practice (Steiber et al., 2007). SGA is approved as a high applicable method to assess nutritional status with PEW in haemodialysis patients (Vegine et al., 2011). SGA scoring assess and grade into three degree on each contains which are weight include weight change, dietary intake and its change, gastrointestinal symptoms, functional capacity and its change, subcutaneous fat on three points of the body, muscle wasting on eight points of the body, oedema and ascites. However, a cohort study showed that malnutrition was not diagnosed in any patients when measured using SGA in patients who had been identified using measurement of serum albumin, BMI, and a history of weight loss (Gurreebun, Hartley, Brown, Ward, & Goodship, 2007). Furthermore, SGA score between the two examiners which were a nephrologist and a qualified dietician were compared in a study and the result founded that the agreement of SGA scores were significantly differed (Cooper et al., 2002). Hence, SGA scoring is convenient for daily nutritional assessment in practical; it can vary between assessors since this method is subjective.

Normalised Protein Catabolic Rate (nPCR) nPCR is a nutritional predictors of early mortality in incident hemodialysis patients, therefore it is used to assess dietary protein intake in dialysis patients. PCR calculated by urea kinetic analysis as a reliable method to determine protein intake of patients. PCR indicates nitrogen losses and normalised PCR (nPCR) can show nitrogen utilisation in subtle individual variances. Although a single PCR measurement does not indicate everyday diet or metabolic changes, c...

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...o malnutrition status, both the patient and care provider needs to put great effort to recover from the severe condition to the normal or better condition. In other words, when the identification of PEW is early, the gap to fill for bring the malnourished patient up to normal status can be smaller. Therefore, early detection of PEW and early intervention is meaningfully important. To enable the early intervention of PEW, nutritional assessment should be simple, harmless, cost less, to enable regularly and applicable on wider patients without exclusion depending on medical treatment of patients such as having pacemaker implantation. Hence, discovering usefulness of pinch strength which is very simple, less effort, cheap, harmless, and do not require huge effort on patients, as a muscle mass index will be meaningful because of its applicability in the daily practice.