Signs of protein-energy malnutrition are common in maintenance hemodialyis (HD)
patients and are associated with increased morbidity and mortality. To evaluate the nutritional
status and relationship between various parameters used for assessing malnutrition, we performed
a cross-sectional study in 37 HD patients treated with thrice weekly sessions for at least two
weeks. Global nutritional status was evaluated by the dual-energy X-ray absorptiometry (DEXA)
scan. Body weight and several laboratory values, including serum albumin (Salb), serum
prealbumin, bicarbonate, cholesterol, serum C-reactive protein (SCRP), and hemoglobin, were
recorded. Dose of dialysis was evaluated by urea kinetic modeling. The patients were subdivided
into two groups based on body mass index: group I, normal nutritional status (71%) and group II,
malnutrition (29%). The clinical factors associated with malnutrition included advanced age and
cardio-vascular diseases (CVD), decreased fat mass (FM) measured by DEXA, low Salb and
prealbumin, and severe anemia. The Salb level was not only a predictor of nutritional status, but
also was independently influenced by age and SCRP, which was more common in malnourished
patients than in patients with normal nutritional status. Both low Kt/V and less weekly dialysis
time were associated with malnutrition. The FM and lean body mass (LBM) calculated by DEXA
correlated with CVD and other markers of malnutrition (Salb, total cholesterol).