CKD: Nutritional Status: Laboratory Measures (2018)

Assessment
Is there evidence to support the use of albumin levels for assessing nutritional status in adults with CKD 1-5D and post-transplant?
- Conclusion
  Lower albumin levels do predict mortality in hemodialysis (three studies) and peritoneal dialysis (two studies) patients. There is a weak association with common body composition measurements in hemodialysis patients (seven studies).
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Is there evidence to support the use of albumin levels for assessing nutritional status in adults with CKD 1-5D and post-transplant?
- Search Plan and Results: CKD: Assessment: Laboratory Measures (2018)
Is there evidence to support the use of inflammatory markers for assessing nutritional status in adults with CKD 1-5D and post-transplant?
- Conclusion
  There was no evidence testing the validity or reliability of using inflammatory markers to examine nutritional status. While many studies found correlations between higher inflammatory markers and poorer nutritional status (10 studies), findings varied according to comparison measure. The relationship between BMI and inflammatory marker levels was unclear, and there may be a u-shaped relationship (three studies). Malnutrition inflammation score was associated with inflammatory marker status in kidney transplant patients (one study).
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Is there evidence to support the use of inflammatory markers for assessing nutritional status in adults with CKD 1-5D and post-transplant?
- Search Plan and Results: CKD: Assessment: Laboratory Measures (2018)
Is there evidence to support the use of PNA/PCR for assessing nutritional status in adults with CKD 1-5D and post-transplant?
- Conclusion
  Normalized protein catabolic rate (nPNA) was a predictor of albumin levels (two studies) and mortality (one study) in hemodialysis patients. In peritoneal dialysis patients, results were unclear regarding the relationship between normalized protein catabolic rate (nPCR) and body composition measurements, and relationships with other measures of nutritional status varied.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Is there evidence to support the use of PNA/PCR for assessing nutritional status in adults with CKD 1-5D and post-transplant?
- Search Plan and Results: CKD: Assessment: Laboratory Measures (2018)
Is there evidence to support the use of pre-albumin levels for assessing nutritional status in adults with CKD 1-5D and post-transplant?
- Conclusion
  Pre-albumin levels were associated with normlaized protein catabolic rate (nPCR) (one study), inflammatory markers (two studies), lean and fat tissue index (one study) and mortality (one study) and hospitalizations (one study) in hemodialysis patients. However, there were no studies examining validity and/or reliability of this measure compared to a gold standard.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Is there evidence to support the use of pre-albumin levels for assessing nutritional status in adults with CKD 1-5D and post-transplant?
- Search Plan and Results: CKD: Assessment: Laboratory Measures (2018)
Is there evidence to support the use of testosterone levels for assessing nutritional status in adults with CKD 1-5D and post-transplant?
- Conclusion
  Testosterone levels were associated with increased c-reactive protein (CRP) levels and decreased measures of muscle mass and nutritional status in male, Stages 2-4 CKD patients (one study).
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Is there evidence to support the use of testosterone levels for assessing nutritional status in adults with CKD 1-5D and post-transplant?
- Search Plan and Results: CKD: Assessment: Laboratory Measures (2018)