By Jennifer Tarantola, RD, LDN

Malnutrition can not be diagnosed by any single test or measurement. According to the Kidney Disease Outcomes Quality Initiative (K/DOQI), the following measures should be considered when evaluating a person’s nutritional status1:

1. Blood tests:

• The most commonly used blood test to evaluate a person’s nutritional status is serum albumin. Albumin is the most abundant protein found in the body. Most research recommends that CKD patients maintain serum albumin levels at or above 4.0 g/dL.
• Other blood tests that your health care professional may use to evaluate nutritional status include pre-albumin, creatinine, urea nitrogen and cholesterol.

2. Body weight: Ideal Body Weight can be determined using a variety of formulas; below is one example:

• For women (based on medium frame): 100 pounds for the first 5 feet, plus 5 pounds for every inch after 5 feet.
• For example, a woman that is 5 feet, 5 inches would have an ideal body weight of 125 pounds (100 pounds for 5 feet + 25 pounds for 5 inches).
• For men (based on medium frame): 106 pounds for the first 5 feet, plus 6 pounds for every inch after 5 feet. 
• For example, a man that is 5 feet, 9 inches would have an ideal body weight of 160 pounds (106 pounds for 5 feet + 54 pounds for 9 inches). 

A patient is considered underweight if their body weight is less than 100% of their ideal body weight.
Usual Body Weight is also an important tool in determining nutritional status. Weight loss of > 5% in one month, or > 10% in six months is considered severe weight loss and is a strong indicator of malnutrition. 

3. Dietary interviews and food diaries:

• Your health care professional may conduct dietary interviews or ask you to keep food diaries. This can provide important information such as an estimate of protein and calorie intake, portion sizes, timing of meals and the quality of a person’s diet.

Jennifer Tarantola, RD, LDN, currently works with peritoneal and hemodialysis patients at Fresenius Medical Care in Chicago. She is also involved with Treatment Options education for CKD patients.

This article is a side-bar to an article that appears in the March 2009 issue of aakpRENALIFE.