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Assessment of nutritional status in hemodialysis patients

Shweta Bansal, MD, FASN
Monique E Cho, MD
Srinivasan Beddhu, MD
Section Editor
Steve J Schwab, MD
Deputy Editor
Alice M Sheridan, MD


Dialysis patients are commonly depleted of protein and energy stores [1-5]. The degree to which protein and energy depletion is the result of deficient nutrition or, alternatively, protein and energy wasting is unclear. In 2009, the International Society of Renal Nutrition and Metabolism (ISRNM) recommended the terminology protein-energy wasting (PEW) syndrome to describe the loss of body protein mass and fuel reserves in patients with end-stage renal disease (ESRD) [6].

The assessment of nutritional status is a routine part of the care of maintenance dialysis patients in order to allow early recognition and treatment of PEW syndrome. Markers of PEW are among the strongest predictors of morbidity and mortality in ESRD patients [3,7].

This topic reviews our approach to the assessment of nutritional status among hemodialysis patients. The pathogenesis and treatment of PEW among hemodialysis patients are discussed elsewhere. (See "Pathogenesis and treatment of malnutrition in maintenance hemodialysis patients".)

The assessment of nutritional status and the prevention and treatment of malnutrition among peritoneal dialysis patients are discussed elsewhere. (See "Nutritional status and protein intake in peritoneal dialysis patients".)


We perform monthly nutritional assessments of all hemodialysis patients. Our approach includes a dietary assessment, physical examination, and laboratory examination.

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Literature review current through: Dec 2017. | This topic last updated: Jan 19, 2017.
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