Role of Subjective Global Assessment (SGA), Malnutrition Inflammation Score (MIS), and Global Leadership Initiative for Malnutrition (GLIM) in Nutritional Assessment of Patients with ESRD on Hemodialysis

Background: Malnutrition is significantly prevalent in haemodialysis patients & is associated with an increased risk of morbidity and mortality. Accurate nutritional assessment is essential for guiding therapy and outcomes. This study compares the effectiveness of SGA, MIS, and GLIM scores in evaluating nutritional status and response to dietary interventions in ESRD patients to improve outcomes & quality of life. Methods: This is an observational and quasi-experimental clinical study with Sample size of 55 ELIGIBILITY: Patients aged between 18-75 years who are on maintenance haemodialysis twice/thrice per week.Patient evaluation was done on the day of admission, 3 months & 6 months later post intervention. Results: Study included 55 patients (38 males,17 females; mean age 52.58 years) wherein Hypertension was the leading cause of CKD. Nutritional assessments showed significant improvement after intervention such as SGA scores improved from 4.42 to 3.25, and MIS from 13.03 to 10.03 over 6 months(p < 0.05),GLIM showed less sensitivity to change. Malnutrition prevalence varied across tools, with SGA and MIS being more responsive. Improvements in serum albumin & total protein levels corresponded with nutritional gains, highlighting SGA as the most efficient tool for tracking changes over time. Conclusion: In this study, hypertension (81.8%) was the leading contributor to CKD, followed by diabetes (12.7%), contrasting global trends.The SGA tool proved to be the most reliable, practical, and sensitive tool for tracking nutritional improvement in ESRD patients. Multidisciplinary care involving nephrologists & dietitians is essential for optimizing CKD management and promoting holistic, diet-focused patient care in patients.