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Table 1 ISRNM criteria for the clinical diagnosis of PEW in maintenance dialysis patients

From: Effects of a six-month intradialytic physical ACTIvity program and adequate NUTritional support on protein-energy wasting, physical functioning and quality of life in chronic hemodialysis patients: ACTINUT study protocol for a randomised controlled trial

Criteria*

Serum chemistry:

 
 

Serum albumin < 3.8 g per 100 ml

 

Serum prealbumin < 30 mg per 100 ml

 

Serum cholesterol < 100 mg per 100 ml

Body mass:

 
 

BMI < 23

 

Unintentional weight loss over time: 5% over 3 months or 10% over 6 months

 

Total body fat percentage < 10%

Muscle mass:

 
 

Muscle wasting: reduced muscle mass 5% over 3 months or 10% over 6 months

 

Reduced mid-arm muscle circumference area (reduction > 10% in relation to 50th percentile of reference population)

 

Creatinine appearance

Dietary intake:

 
 

Unintentional low dietary protein intake <0.80 g.kg-1.day-1 for at least 2 months

 

Unintentional low dietary energy intake <25 kcal.kg-1.day-1 for at least 2 months

  1. *At least three out of the four listed categories (and at least one test in each of the selected category) must be satisfied for the diagnosis of kidney disease related PEW. Optimally, each criterion should be documented on at least three occasions, preferably 2-4 weeks apart.
  2. ISRNM, international society of renal nutrition and metabolism; PEW, protein-energy wasting; BMI, body mass index.