Related Experiment Video
Updated: Jun 17, 2025
Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice
Published on: August 9, 2013
Modified creatinine index for predicting prognosis in hemodialysis patients: a systematic review and meta-analysis
Tao Ye1, Jingfang Du1, Pian Li1
1School of Clinical Medicine, Hebei University of Engineering, Handan, China.
Insights
The modified creatinine index (mCI) is linked to better nutritional status and survival in hemodialysis (HD) patients. Monitoring mCI can help improve prognosis for individuals undergoing HD treatment.
Area of Science:
- Nephrology
- Clinical Nutrition
- Biostatistics
Background:
- Conflicting results exist regarding the modified creatinine index (mCI) and prognosis in hemodialysis (HD) patients.
- A comprehensive meta-analysis is needed to clarify the role of mCI in predicting outcomes for HD patients.
Purpose of the Study:
- To systematically evaluate the association between the modified creatinine index (mCI) and prognosis in patients undergoing hemodialysis (HD).
- To assess the utility of mCI as a prognostic marker in the HD population.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Embase, Web of Science, Cochrane) up to March 2024.
- Statistical analyses were performed using Stata 15.0, RevMan 5.4, and Meta DiSc 1.4 software to synthesize extracted data.
Main Results:
- mCI positively correlates with nutritional markers (BMI, albumin, nPCR) in HD patients.
- Lower mCI levels were observed in deceased HD patients compared to survivors, indicating poorer prognosis.
- A low mCI was significantly associated with increased all-cause mortality and decreased overall survival (OS) in HD patients.
- mCI demonstrated moderate diagnostic accuracy for sarcopenia in both male and female HD patients.
Conclusions:
- The modified creatinine index (mCI) serves as a valuable prognostic marker for patients on hemodialysis.
- Regular monitoring of mCI can aid in optimizing management strategies and enhancing the overall prognosis for HD patients.
Background:
Currently, several studies have explored the association between the modified creatinine index (mCI) and prognosis in patients on hemodialysis (HD). However, some of their results are contradictory. Therefore, this study was conducted to comprehensively assess the role of mCI in predicting prognosis in HD patients through meta-analysis.
Methods:
We searched and screened literature from PubMed, Embase, Web of Science, and Cochrane databases from their establishment until March 2024. Relevant data were extracted. The statistical analysis was performed using Stata 15.0, RevMan 5.4, and Meta DiSc 1.4 software.
Results:
The results showed a positive association between mCI and nutritional status in HD patients (BMI r = 0.19, 95% CI: 0.1-0.28, p = .000; albumin r = 0.36, 95% CI: 0.33-0.39, p = .000; normalized protein catabolic rate (nPCR) r = 0.25, 95% CI: 0.13-0.38, p = .000). In addition, mCI in deceased HD patients was significantly lower than that in HD survivors (SMD = -0.94, 95% CI: -1.46 to -0.42, p = .000). A low mCI was associated with an increased risk of all-cause death in HD patients (HR = 1.95, 95% CI: 1.57-2.42, p = .000). In addition, a low mCI was significantly associated with decreased overall survival (OS) in HD patients (HR = 3.01, 95% CI: 2.44-3.70, p = .000). mCI showed moderate diagnostic accuracy for sarcopenia in both male and female HD patients (male AUC = 0.7891; female AUC = 0.759).
Conclusions:
The mCI can be used as a prognostic marker for HD patients, and monitoring mCI may help to optimize the management of HD and improve overall prognosis in patients.
Related Concept Videos
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:23Renal Clearance
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:27Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:07Determination of Renal Drug Clearance: Graphical and Midpoint Methods
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...