Comprehensive Nutritional Assessment in Hemodialysis Patients: Evaluating SGA, Serum Albumin, and Clinical Outcomes

Background: Chronic kidney disease (CKD) patients on hemodialysis are at high risk of malnutrition, which significantly impacts morbidity and mortality. Assessing nutritional status using the Subjective Global Assessment (SGA) and comparing it with serum albumin levels can provide insights into the reliability and utility of these tools in predicting clinical outcomes. Aim and Objectives: To assess nutritional status using SGA, compare it with serum albumin levels, and evaluate their correlation with one-year clinical outcomes in CKD patients on hemodialysis. Materials and Methods: This prospective observational study included 150 adult CKD patients undergoing hemodialysis at Gandhi Medical College and associated hospitals in Bhopal over two years. Nutritional assessment was performed using SGA and anthropometric measurements, including BMI, mid-arm circumference (MAC), triceps skinfold thickness (TSFT), and mid-arm muscle circumference (MAMC). Biochemical parameters such as haemoglobin, serum albumin, urea, and creatinine were analyzed. Associations between SGA, serum albumin, and clinical outcomes were assessed using statistical tests, with significance at p < 0.05. Results: The mean age of the study population was 42.71 years (SD = 13.82), with 57.3% males. Nutritional assessment using SGA classified 59.4% of patients as having mild to moderate malnutrition, 37.3% as well-nourished, and 3.3% as severely malnourished. Anthropometric measures such as BMI, MAC, TSFT, and MAMC significantly correlated with SGA categories (p < 0.05). Serum albumin levels, while significantly different across SGA categories (p = 0.026), showed inconsistent trends, limiting their utility as a sole nutritional marker. Patients with lower SGA scores had poorer one-year outcomes, including increased hospitalizations and complications. Conclusion: Malnutrition is highly prevalent among CKD patients on hemodialysis, and SGA is a reliable tool for nutritional assessment. While anthropometric parameters align closely with SGA, serum albumin levels alone are insufficient for comprehensive nutritional evaluation. Integrating SGA with clinical, anthropometric, and biochemical assessments is essential for optimizing nutritional management in this vulnerable population.