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Malnutrition-inflammation score predicts long-term mortality in Chinese PD patients
Ting He1, Xin An, Hai-Ping Mao
1Department of Nephrology, The First Affiliated Hospital, Guangzhou, China.
Background:
Malnutrition-Inflammation Score (MIS) has proved to predict the prospective mortality in maintenance hemodialysis (MHD) patients. However, its value of long-term mortality predictability in peritoneal dialysis (PD) patients has not been adequately studied.
Methods:
A total of 155 chronic stable PD patients from November 2005 to December 2006 were enrolled. At baseline, the MIS, Subjective Global Assessment (SGA), as well as clinical, laboratory, and anthropometric parameters were recorded. All patients were followed until October 2009 to evaluate mortality as a primary outcome.
Results:
The MIS correlated very well with SGA and other nutrition and inflammation markers. Patients with a higher MIS had a worse survival rate compared to those with lower MIS. After adjusting for potential confounding factors, one unit increase of MIS was associated with a 1.27-fold greater death risk (hazard ratio: 1.27, 95% confidence interval: 1.19 - 1.36; p < 0.001). MIS had a superior mortality predictability compared with SGA. Moreover, univariate and multivariate analyses denoted MIS, age, dialysis vintage, and comorbidities as independent predictors of total mortality.
Conclusion:
MIS is a promising marker for malnutrition inflammation assessment and an independent predictor of long-term mortality in Chinese PD patients.
Insights
The Malnutrition-Inflammation Score (MIS) effectively predicts long-term mortality in peritoneal dialysis (PD) patients. Higher MIS scores indicate a greater risk of death, outperforming Subjective Global Assessment (SGA).
Area of Science:
- Nephrology
- Clinical Nutrition
- Epidemiology
Background:
- The Malnutrition-Inflammation Score (MIS) predicts mortality in hemodialysis patients.
- Its long-term mortality predictive value in peritoneal dialysis (PD) patients remains understudied.
Purpose of the Study:
- To evaluate the MIS as a predictor of long-term mortality in PD patients.
- To compare the predictive performance of MIS with Subjective Global Assessment (SGA).
Main Methods:
- 155 stable PD patients were enrolled between November 2005 and December 2006.
- Baseline MIS, SGA, clinical, laboratory, and anthropometric data were collected.
- Patients were followed until October 2009 for mortality outcomes.
Main Results:
- MIS strongly correlated with SGA and other nutrition/inflammation markers.
- Higher MIS was associated with significantly worse survival rates.
- Each one-unit increase in MIS raised the death risk by 1.27-fold (HR: 1.27, 95% CI: 1.19-1.36, p < 0.001).
- MIS demonstrated superior mortality predictability compared to SGA.
- Independent predictors of mortality included MIS, age, dialysis vintage, and comorbidities.
Conclusions:
- MIS is a valuable tool for assessing malnutrition and inflammation in PD patients.
- MIS independently predicts long-term mortality in Chinese PD patients.