Use of the subjective global assessment to predict health-related quality of life in chronic kidney disease stage 5 patients on maintenance hemodialysis.

ABSTRACT

OBJECTIVE: The purpose of this study was to determine whether a subjective global assessment (SGA) score was predictive of health-related quality of life (HRQoL) in stage 5 chronic kidney disease patients on maintenance hemodialysis (MHD). DESIGN AND SETTING: This was a cross-sectional secondary data analysis of MHD patients receiving therapy 3 times a week at dialysis centers located in the United States, Canada, and New Zealand. Nutritional status was assessed using the 7-point SGA. HRQoL was determined using the Medical Outcomes Study 36-item Short Form (SF-36). RESULTS: The study sample consisted of 94 men (n = 47, 50%) and women (n = 47, 50%), with a mean age of 64.9 ± 12.9 years. The mean SGA score at the end point of the study (6 months) was 5.8 ± 1.1. Participants had a mean HRQoL physical health score of 36.5 ± 9.3 at 6 months, indicating a worse physical health state. The HRQoL mental health summary score was within the normal range (50.5 ± 11.1). After controlling for confounders in the hierarchical regression models, the SGA score significantly predicted HRQoL physical health (R(2) change = 0.124; P = .012). No association was found between the SGA score and HRQoL mental health (P = .925). CONCLUSIONS: The SGA score is a significant predictor of HRQoL physical health. Given that nutritional status impacts HRQoL and that decreased HRQoL in patients on MHD is associated with mortality, complications, and reduced compliance with treatment, using the SGA to measure nutritional status can be a tool to help identify dialysis patients with a lower HRQoL in terms of physical health.