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Perit Dial Int 26(6): 705-711 2006
© 2006 International Society for Peritoneal Dialysis
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Clinical

MALNUTRITION-INFLAMMATION SCORE IS A USEFUL TOOL IN PERITONEAL DIALYSIS PATIENTS

Baris Afsar1, Siren Sezer1, Fatma Nurhan Ozdemir1, Huseyin Celik1, Rengin Elsurer1 and Mehmet Haberal2

1 Department of Nephrology and2 Department of General Surgery, Baskent University Hospital, Ankara, Turkey

Correspondence to: B. Afsar, 3. Cadde 50, Sokak 9/8 06500 Bahçelievler, Ankara, Turkey.
afsarbrs{at}yahoo.com

{diamondsuit} 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.

{diamondsuit} 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.

{diamondsuit} 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).

{diamondsuit} 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.

KEY WORDS: Malnutrition-Inflammation Score; Subjective Global Assessment; peritonitis; hospitalization; protein-energy malnutrition; anthropometric measurements.

Received 11 December 2005; accepted 3 April 2006.




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