Abstract
Purpose
The main purpose of this study is to correlate the significance of the malnutrition inflammation score (MIS) and the waist-to-hip ratio (WHR) in the prediction of mortality in hemodialysis patients.
Methods
The study was conducted from March 2016 to April 2020, covering 100 hemodialysis patients. Anthropometric measures (Waist circumference (WC), Hip circumference (HC), Waist-to-hip ratio (WHR), Caliper and BMI) and biomarkers of inflammation (IL6, hsCRP) and nutrition (Transfferin, Albumin) were determined and for the above-mentioned biomarkers, we monitored all-cause mortality for 4 years. The hemodialysis patients were divided in three groups based on their MIS score.
Results
In this prospective, longitudinal study, we enrolled 100 patients (54 males and 46 females) with a median age of 58 (51–65) years. All patients were divided into three groups according to MIS score values. We performed univariate Cox regression survival analysis for a period of 4 years, and then included for multivariate survival Cox regression analysis well-defined nutritional markers: BMI, mid-arm circumference, WHR and MIS score. The MIS score was demonstrated to be the best independent predictor of 4-year mortality in our study (p < 0.001).
Conclusion
The results of our study have shown that there is no significance of WHR in the prediction of mortality in hemodialysis patients, but that the MIS score is a strong, independent predictor of all-cause 4-year mortality.
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References
Lopes MB et al (2017) Additional contribution of the malnutrition–inflammation score to predict mortality and patient reported outcomes as compared with its components in a cohort of African descent hemodialysis patients. J Ren Nutr 27(1):45–52
Obi Y et al (2015) Latest Consensus and Update on Protein Energy-Wasting in Chronic Kidney Disease. Curr Opin Clin Nutr Metab Care 18(3):254–262
Harvinder GS et al (2016) Dialysis Malnutrition and Malnutrition Inflammation Scores: screening tools for prediction of dialysis—related protein-energy wasting in Malaysia Asia. Pac J Clin Nutr 25(1):26–33
Sohrabi Z et al (2015) Malnutrition-inflammation score and quality of life in hemodialysis patients: is there any correlation? Nephro Urol Mon. 7(3):e27445
Postorino M, Marino C, Tripepi G, Zoccali C (2009) Abdominal obesity and all-cause and cardiovascular mortality in end-stage renal disease. J Am Coll Cardiol 53(15):1265–1272
Kuma A, Uchino B, Ochiai Y et al (2019) Relationship between abdominal adiposity and incident chronic kidney disease in young- to middle-aged working men: a retrospective cohort study. Clin Exp Nephrol 23(8):76–84
Zhou Q, Li YQ, Zhu SS et al (2016) Association of waist-to-hip ratio with chronic kidney disease in non-diabetic subjects. J South Med Univ 36(9):1221–1225
Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH (2001) A malnutrition inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. Am J Kidney Dis 38(6):1251–1263
Amparo FC, Kamimura MA, Molnar MZ, Cuppari L, Lindholm B, Amodeo C et al (2015) Diagnostic validation and prognostic significance of the Malnutrition-Inflammation Score in nondialyzed chronic kidney disease patients. Nephrol Dial Transpl 30(5):821–828
Rambod M, Bross R, Zitterkoph J, Benner D, Pithia J, Colman S et al (2009) Association of Malnutrition-Inflammation Score with quality of life and mortality in hemodialysis patients: a 5-year prospective cohort study. Am J Kidney Dis 53(2):298–309
Lu JL, Kalantar-Zadeh K, Ma JZ, Quarles LD, Kovesdy CP (2014) Association of body mass index with outcomes in patients with CKD. J Am Soc Nephrol 25(8):2088–2096
Stenvinkel P et al (2016) Inflammation modifies the paradoxical association between body mass index and mortality in hemodialysis patients. J Am Soc Nephrol 27(7):1479–1486
He Y et al (2016) The association of chronic kidney disease and waist circumference and waist-to-height ratio in Chinese urban adults. Medicine 95:25
Vogt BP, Caramori JCT (2017) Recognition of visceral obesity beyond body fat: assessment of cardiovascular risk in chronic kidney disease using anthropometry. Nutrire 42:19
Song Yang BS et al (2018) Comparison of the correlates between body mass index, waist circumference, waist-to height ratio, and chronic kidney disease in a rural chinese adult population. J Renal Nutr. 13(7):1–9
Acknowledgments
This research was supported by technical and medical staff of Clinic for nephrology and Center for laboratory diagnostic, Clinical center of Montenegro.
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There are no Grants and other funding for conducted survey.
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Study was approved by Ethical Committee Clinical Center of Montenegro, and was performed in accordance with the relevant ethical standards and Declaration of Helsinki.
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Prelevic, V., Antunovic, T., Radunovic, D. et al. Malnutrition inflammation score (MIS) is stronger predictor of mortality in hemodialysis patients than waist-to-hip ratio (WHR)-4-year follow-up. Int Urol Nephrol 54, 695–700 (2022). https://doi.org/10.1007/s11255-021-02954-z
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DOI: https://doi.org/10.1007/s11255-021-02954-z