Subjective Global Assessment (SGA) The SGA score is currently commonly used as a valid and reliable indicator of nutritional status in practice (Steiber et al., 2007). SGA is approved as a highly applicable method to assess nutritional status with PEW in hemodialysis patients (Vegine et al., 2011). The SGA score evaluates and classifies each of them into three grades, including weight including weight change, dietary intake and its change, gastrointestinal symptoms, functional capacity and its change, three-point subcutaneous fat of the body, muscle atrophy on eight points of the body, edema and ascites. However, a cohort study demonstrated that malnutrition was not diagnosed in any patient when measured using the SGA in patients who were identified using measurement of serum albumin, BMI, and with a history of weight loss (Gurreebun , Hartley, Brown, Ward, & Goodship, 2007). Furthermore, in one study SGA scores were compared between two examiners, a nephrologist and a registered dietician, and the result found that the agreement of SGA scores was significantly different (Cooper et al., 2002). Therefore, the SGA score is useful for daily nutritional assessment in practice; may vary from one rater to another as this method is subjective. Normalized protein catabolic rate (nPCR) nPCR is a nutritional predictor of early mortality in incident hemodialysis patients, therefore it is used to evaluate dietary protein intake in dialysis patients. PCR calculated by urea kinetic analysis as a reliable method to determine patients' protein intake. PCR indicates nitrogen losses and normalized PCR (nPCR) can show nitrogen utilization in subtle individual variations. Although a single PCR measurement does not indicate daily diet or metabolic changes, c...... middle of paper ......or state of malnutrition, both the patient and the healthcare provider must make great efforts to recover from serious condition to normal condition or better. In other words, when the identification of PEW is early, the gap to be filled to return the malnourished patient to a state of normality may be smaller. Therefore, early diagnosis of PEW and early intervention are significantly important. To enable early intervention of PEW, nutritional assessment should be simple, harmless, less expensive, to be permitted routinely, and applicable to broader patients without exclusion depending on patients' medical treatment such as pacemaker implantation. So, discover the usefulness of grip strength which is very simple, requires less effort, is economical, harmless and does not require huge effort for patients, as a muscle mass index will be significant for its applicability in daily practice.