Validation of CNAQ for assessing the appetite status of maintenance hemodialysis patients in Taiwan

CNAQ (Council on Nutrition Appetite Questionnaire) was developed by the Council for Nutritional Strategies in Long-Term Care of the United States. It is a tool for evaluating the appetite status of community-dwelling adults and nursing home residents. The tool has been shown to be useful because of its simplicity and efficiency. This study attempted to examine whether this tool can be applied to assess the appetite status of maintenance hemodialysis patients in Taiwan. One hundred and eight community-living patients from three hemodialysis centers were chosen as study samples. A structured-questionnaire elicited personal data and health conditions, in addition to answers to questions in the CNAQ during a routine dialysis session. Anthropometric measurements were also carried out. Biochemical indicators were obtained from their routine tests. CNAQ identified 58 of the 108 patients (53.7%) poor appetite and 50 (46.3 %) good appetite. Subjects' CNAQ scores were significantly correlated with serum albumin (P<0.01), an indicator of nutritional status. Most nutritional indicators including weight change (P<0.01), serum creatinine (P<0.01), calf circumference index (P<0.05), mid-arm circumference index (P<0.05), hip circumference (P<0.01), physical activity (P<0.01) and number of chronic diseases (P<0.05) showed stronger correlations with CNAQ scores than with serum albumin concentrations. These results suggest that CNAQ is a more reliable indicator of nutritional status than serum albumin for hemodialysis patients. The simplicity, efficiency and low cost of CNAQ make this tool a method of choice for assessing the appetite status of maintenance hemodialysis patients.