The evidence against malnutrition as a prominent problem for chronic dialysis patients.

A large number of dialysis patients have been classified as being malnourished because of anthropometric measurements and laboratory values that are similar to those in patients with protein-energy malnutrition. Malnutrition implies that abnormalities can be reversed with better nutrition. However, this approach of providing more nutrients in the diet has been unsuccessful in reversing these changes, suggesting that a diagnosis of malnutrition is generally a misdiagnosis for dialysis patients In this review we discuss mechanisms that cause a loss of protein stores, muscle mass, albumin, and other plasma proteins in dialysis patients. We also review the shortcomings of techniques that are used to measure the nutritional status of these patients.