Mariana Clementoni Costa Borges1, Barbara Perez Vogt1, Luis Cuadrado Martin1, Jacqueline Costa Teixeira Caramori2. 1. Faculdade de Medicina de Botucatu, UNESP Univ Estadual Paulista, Department of Clinical Medicine, Botucatu, São Paulo, Brazil. 2. Faculdade de Medicina de Botucatu, UNESP Univ Estadual Paulista, Department of Clinical Medicine, Botucatu, São Paulo, Brazil. Electronic address: jteixeir@fmb.unesp.br.
Abstract
BACKGROUND: Malnutrition is a strong predictor of mortality on hemodialysis patients, especially when it is associated with inflammation. Malnutrition Inflammation Score (MIS) is a simple and low cost tool which assesses the presence of malnutrition associated with inflammation. Therefore, the aim is to evaluate if MIS is associated with mortality in patients on maintenance hemodialysis and establish a cut-off to predict mortality at different follow-up periods. METHODS: Observational retrospective cohort study including 215 patients on hemodialysis between July 2012 and June 2014, censored until November 2015. MIS was used to assess patient's nutritional status at the moment they were enrolled in the study. They were followed for at least 18 months. RESULTS: At the end of 18 months, 38 (17.7%) deaths, 20 renal transplants (9.3%), four facilities transference (1.9%), three dialysis method change (1.4%) and one renal function recovery (0.5%) were observed. One hundred seventy one patients completed at least 24 months of follow-up, and during this additional period, there were five deaths and one renal transplant more. Score higher than 7 points was able to predict mortality for both follow-up periods using sensitivity and specificity analysis and ROC curves. Using this cut-off on Kaplan-Meier survival curve, it was possible to confirm the association of MIS with all-cause mortality at 18 months and 24 or more months of follow-up. Finally, Cox multivariate analysis adjusted for demographic, clinical and nutritional variables showed MIS as the only significant predictor of mortality. CONCLUSION: MIS is an independent predictor of mortality in hemodialysis patients.
BACKGROUND:Malnutrition is a strong predictor of mortality on hemodialysis patients, especially when it is associated with inflammation. Malnutrition Inflammation Score (MIS) is a simple and low cost tool which assesses the presence of malnutrition associated with inflammation. Therefore, the aim is to evaluate if MIS is associated with mortality in patients on maintenance hemodialysis and establish a cut-off to predict mortality at different follow-up periods. METHODS: Observational retrospective cohort study including 215 patients on hemodialysis between July 2012 and June 2014, censored until November 2015. MIS was used to assess patient's nutritional status at the moment they were enrolled in the study. They were followed for at least 18 months. RESULTS: At the end of 18 months, 38 (17.7%) deaths, 20 renal transplants (9.3%), four facilities transference (1.9%), three dialysis method change (1.4%) and one renal function recovery (0.5%) were observed. One hundred seventy one patients completed at least 24 months of follow-up, and during this additional period, there were five deaths and one renal transplant more. Score higher than 7 points was able to predict mortality for both follow-up periods using sensitivity and specificity analysis and ROC curves. Using this cut-off on Kaplan-Meier survival curve, it was possible to confirm the association of MIS with all-cause mortality at 18 months and 24 or more months of follow-up. Finally, Cox multivariate analysis adjusted for demographic, clinical and nutritional variables showed MIS as the only significant predictor of mortality. CONCLUSION: MIS is an independent predictor of mortality in hemodialysis patients.
Authors: Bernard Canaud; Stefano Stuard; Frank Laukhuf; Grace Yan; Maria Ines Gomez Canabal; Paik Seong Lim; Michael A Kraus Journal: Clin Kidney J Date: 2021-12-27
Authors: Cristina Martins; Simone L Saeki; Marcelo Mazza do Nascimento; Fernando M Lucas Júnior; Ana Maria Vavruk; Christiane L Meireles; Sandra Justino; Denise Mafra; Estela Iraci Rabito; Maria Eliana Madalozzo Schieferdecker; Letícia Fuganti Campos; Denise P J van Aanholt; Ana Adélia Hordonho; Marcia Samia Pinheiro Fidelix Journal: J Bras Nefrol Date: 2021 Apr-Jun
Authors: Mirey Karavetian; Cosette Fakih El Khoury; Rik Crutzen; Jos M G A Schols; Ruud J G Halfens Journal: J Med Internet Res Date: 2020-07-20 Impact factor: 5.428
Authors: Els Holvoet; Karsten Vanden Wyngaert; Amaryllis H Van Craenenbroeck; Wim Van Biesen; Sunny Eloot Journal: PLoS One Date: 2020-03-04 Impact factor: 3.240
Authors: Floris K Hendriks; Joey S J Smeets; Frank M van der Sande; Jeroen P Kooman; Luc J C van Loon Journal: Nutrients Date: 2019-12-05 Impact factor: 5.717