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Malnutrition-inflammation score is a useful tool in peritoneal dialysis patients
Bariş Afşar1, Siren Sezer, Fatma Nurhan Ozdemir
1Department of Nephrology, Baskent University Hospital, Ankara, Turkey. afsarbrs@yahoo.com
Background:
Malnutrition-Inflammation Score (MIS) is a quantitative assessment tool based on Subjective Global Assessment (SGA) and predicts mortality and morbidity in maintenance hemodialysis patients. However, there are not enough data about the use of MIS in peritoneal dialysis (PD). In this study, relationships between MIS and prospective hospitalization indices, risk of developing peritonitis, anemia indices, and laboratory and anthropometric parameters were analyzed and compared with SGA in PD.
Methods:
50 PD patients (M/F 26/24, age 45.2 +/- 14.9 years, mean PD duration 30.8 +/- 23.1 months) were included. The same physician performed the SGA and MIS evaluations. Clinical, laboratory, and anthropometric parameters were measured.
Results:
18 patients were classified as SGA-A (without malnutrition), 24 as SGA-B (with moderate malnutrition), and 8 as SGA-C (with severe malnutrition). Increment in MIS was concordant with SGA groups A to C (p < 0.0001). Peritonitis rate, number of hospitalizations, total number of hospitalization days, erythropoietin requirements, C-reactive protein (CRP), and ferritin levels were positively correlated with MIS (p < 0.0001). Midarm muscle circumference (p = 0.04), albumin (p < 0.0001), prealbumin (p = 0.001), creatinine (p = 0.04), hemoglobin (p = 0.003), transferrin (p < 0.0001), and cholesterol (p = 0.009) were negatively correlated with MIS. Correlation coefficients of hospitalization indices, peritonitis rate, anemia indices, erythropoietin requirements, albumin, prealbumin, CRP, and anthropometric parameters were higher with MIS than with SGA. In logistic regression analysis, a higher MIS was independently associated with a higher risk of future hospitalization (p = 0.029, odds ratio 2.14, confidence interval 1.082-4.146).
Conclusions:
This study demonstrated that MIS significantly correlated with clinical, nutritional, inflammatory, and anthropometric parameters and anemia indices in PD patients, and that those correlations were stronger than those with SGA.
Insights
The Malnutrition-Inflammation Score (MIS) effectively assesses nutritional status in peritoneal dialysis (PD) patients, correlating strongly with clinical outcomes and laboratory markers. MIS proves more effective than Subjective Global Assessment (SGA) in predicting hospitalization risk in PD.
Area of Science:
- Nephrology
- Clinical Nutrition
- Internal Medicine
Background:
- The Malnutrition-Inflammation Score (MIS) is validated for hemodialysis patients but understudied in peritoneal dialysis (PD).
- Assessing nutritional status and inflammation is crucial for PD patient outcomes.
- Existing tools like Subjective Global Assessment (SGA) may have limitations in PD.
Purpose of the Study:
- To investigate the relationship between MIS and various clinical indices in PD patients.
- To compare the efficacy of MIS against SGA in assessing nutritional and inflammatory status.
- To determine MIS's predictive value for hospitalization and peritonitis in PD.
Main Methods:
- A cohort of 50 PD patients was evaluated.
- Malnutrition-Inflammation Score (MIS) and Subjective Global Assessment (SGA) were performed by the same physician.
- Clinical, laboratory, and anthropometric parameters were systematically measured.
Main Results:
- MIS showed strong concordance with SGA classifications (A, B, C).
- Higher MIS correlated positively with peritonitis rates, hospitalizations, and inflammatory markers (CRP, ferritin).
- MIS demonstrated stronger correlations with hospitalization indices, anemia markers, and nutritional parameters than SGA.
Conclusions:
- MIS is a valuable tool for assessing nutritional status, inflammation, and anemia in PD patients.
- MIS provides a more comprehensive assessment than SGA in the PD population.
- Elevated MIS independently predicts an increased risk of future hospitalization in PD patients.
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