Obviously, patients with apparently normal physical build, normal diet intake, and no reason for significant increased nutrient requirements need no further investigation. However, the following types of patient require a more precise assessment.
1. Patients presenting with clinical evidence of malnutrition (marasmus or the hypoalbuminemic form of protein energy malnutrition or a mixed form).
2. Patients with chronic diseases such as cancer, alcoholism, liver disease, and kidney disease, particularly those undergoing aggressive treatment, such as chemotherapy, which impairs nutrient absorption and/or utilization.
3. Patients with acute conditions accompanied by high catabolic rates, such as severe sepsis, trauma, and emergency surgery.
4. Geriatric patients: undernutrition is more frequent in older persons because aging is associated with a physiological anorexia, as well as other causes such as poor dentition, economic problems, and chronic illness. Nutrition-mediated complications are more frequent in these patients.
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