Poster Session：PS 0510 ; Nephrology : Subjective Global Assessment of Nutritional Status and Mortality in Chronic Dialysis Patients: A Nationwide Prospective Observational Cohort Study in Korea

Background: Malnutrition is a common and crucial problem because it is associated with higher mortality in chronic dialysis patients. Subjective global assessment (SGA) has been proven as a clinically adequate method for assessing nutritional status in dialysis patients. We explored the relationships between initial and transitions of SGA and all-cause mortality. Methods: A nation-wide prospective observational cohort study included adult chronic dialysis patients. We selected patients who had baseline and 12 month follow-up SGA. SGA-7 score was categorized as well-nourished (SGA 6~7) and malnourished (SGA 1~5) groups. The changes of SGA were categorized by 4 groups (well-maintained, poorly-maintained, improving, and worsening group). Results: A total of 2,600 patients were selected and mean age was 55.7±14 years old and 57.2% of patients were male. The mean follow-up period was 28.5 months. During the follow-up period, 202 patients (7.8%) were died. The mortality rate in malnourished patients was higher in both incident (5.2% vs. 13%, p<0.001) and prevalent patients (6.3% vs. 20.4%, p<0.001). The survival rate was signifi cantly higher in well-nourished patients in 12 month follow-up (p<0.001). Moreover, in terms of SGA transition, improving and well-maintained groups had better survival rate than worsening group and poor-maintained group. These fi ndings were reproducible even afteradjustment of age, gender, smoking, BMI, comorbidity, serum albumin, cholesterol and hs-CRP (HR 2.913, 95% CI, 1.856-4.573, p<0.001). Conclusions: Malnutrition assessed by SGA was an independent predictor for allcause mortality. Furthermore, the transition of SGA was also correlated with mortality in chronic dialysis patients.