Subjective Global Assessment Is a Useful Method to Detect Malnutrition in Renal Transplant Patients

Adequate nutrition is essential for the well-being of renal transplant patients. While body weight gain is a common widely investigated finding, a considerable fraction of patients exhibit poor nutritional status after successful kidney transplantation. In the present study, the prevalence association with nutritional parameters and clinical data of malnutrition among kidney transplant patients were determined based upon a subjective global assessment. This cross-sectional study in the transplant outpatient clinic included 47 patients (10 women, 37 men) of mean age 37.6 ± 10.2 years. The same dietitian performed the assessment on all patients, including anthropometric measurements of body mass index (BMI), mid-arm circumference, and triceps skinfold thickness. The patient data including medications, number of hospitalizations in the preceding year, and presence of chronic allograft failure were collected from medical records. The mean laboratory values during the last 6 months included hemoglobin, creatinine, albumin, phosphorus, C-reactive protein levels, and lipid profile. The patients were classified into 3 groups defined as A (n = 31, 66%), B (n = 11, 23.4%), and C (n = 5, 10.6%), namely, A, no malnutrition versus B/C, moderate or severe malnutrition. Comparison of the 2 groups revealed the serum albumin (P < .0001), body mass index (P = .02), and mid-arm circumference (P = .02) to be higher in group A than groups B/C. Group B/C patients showed higher levels of C-reactive protein (P < .0001). When compared to the pretransplantation period, the 31 patients in group A included 26 who had increased body mass index after transplantation versus only 3 of 16 patients in groups B/C had (P < .0001). The hospitalization rates were significantly lower in group A (P = .02). Additionally, the patients in group A tended to have a lower frequency of chronic allograft rejection when compared to group B/C subjects (P = .13). In conclusion, assessment of nutritional status of renal transplant patients combined with intervention in the nutritional intake may decrease the morbidity rates in this patient group.