Nutritional Status-Based Clinical Outcomes of Patients with ESKD on Peritoneal Dialysis Using the Subjective Global Assessment: A Single Tertiary Center Prospective Study

Background: Malnutrition is a major challenge among patients with end-stage kidney disease (ESKD) on peritoneal dialysis (PD), contributing to increased morbidity and mortality. Despite the recognized value of the Subjective Global Assessment (SGA) as a practical nutritional screening tool, its routine use in outpatient PD populations remains limited.This study evaluated the prevalence of malnutrition using SGA and its association with clinical outcomes in chronic PD patients. Methods: We conducted a prospective study assessing nutritional status with SGA. We analyzed rates of hospitalization, infection and mortality over the follow-up period. Multivariate analysis identified predictors of adverse outcomes. Results: The study included 152 chronic PD patients with a mean age of 47 years; 55.9% were male. Diabetes (38.2%) and hypertension (54.6%) were the most common comorbidities. Based on SGA, 46.7% of patients were moderately malnourished and 28.9% were severely malnourished. Over the follow-up period, 15.1% of patients required hospitalization, 38.8% developed infections, and 2.6% died. Adverse outcomes were strongly associated with nutritional status: well-nourished patients had the lowest rates of mortality (0%), hospitalization (2.7%), and infection (2.7%), while severely malnourished patients had the highest rates (mortality 9.1%, hospitalization 36.4%, infection 52.3%). Severe malnutrition emerged as the most significant independent predictor of mortality or hospitalization (OR 12.02, 95% CI: 4.6–31.7). Conclusion: Malnutrition is highly prevalent among chronic PD patients and is a potent, independent predictor of infection, hospitalization, and mortality. Our findings highlight the critical value of routine SGA screening in identifying high-risk individuals who may benefit from early, targeted nutritional and clinical interventions. Integrating SGA into standard PD care can enable proactive management, reduce adverse outcomes, and ultimately improve survival and quality of life in this vulnerable population.