Table 4.

Indicators of Nutrition Status and Their Considerations

Indicator	Key considerations
Physical exam	• Relatively quick and easy to obtain
• Body habitus	• Low precision, useful for crude classification of low and high energy and protein stores
• Subcutaneous fat stores	• Should assess multiple sites (head-to-toe examination)
• Muscle stores	• Requires skilled examiner
Anthropometric*	• More precise, quantified and standardized than physical exam methods
• Weight-height indices (e.g., BMI)	• May be confounded by fluid overload and shifts in CKD
• Circumferences	• Many require equipment and/or skilled examiner
• Skinfold thickness
• BIA
• Urine creatinine output
Concentration biomarkers	• Hepatic transport proteins are better indicators of malnutrition risk (Table 5)
• Total cholesterol
• Hepatic transport proteins (e.g., albumin)
Function tests	• Function can be assessed qualitatively as part of physical exam (e.g., strength, mobility, muscle tone)
• Dynamometry
• Frailty tests/indices	• Many require equipment and/or skilled examiner
	• Function affected by training and physical activity

BMI, body mass index; BIA, bioelectrical impedance analysis.

^*Advanced anthropometric measurements such as densitometry, dual x-ray absorptiometry, and imaging and isotope methods are excluded, as impractical for PEW assessment in clinical practice.