As a result of the frequency of malnutrition, periodic assessment of nutritional status should be part of the routine care of dialysis patients to permit early recognition and the institution of appropriate therapy (table 1). Most of the standard methods of assessing nutritional status can be applied to patients with renal failure; however, some of these parameters are altered by uremia. It is therefore helpful to review briefly the characteristics of the different tests that are used
History and physical examination — The history and physical examination can often provide important clues to the patient who might be malnourished. These include: Symptoms such as nausea, vomiting, anorexia, or weight loss or gain. Large interdialytic weight gain is discouraged because it is thought to reflect excessive fluid and sodium intake. In some cases, however, over time, increased body weight gain may represent improved nutritional status [13]. A careful assessment should be performed to distinguish between these possibilities.