Document Detail


Malnutrition-inflammation score associated with atherosclerosis, inflammation and short-term outcome in hemodialysis patients.
MedLine Citation:
PMID:  20364569     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Malnutrition-Inflammation Score (MIS) has been proposed as a new quantitative system for assessment of malnutrition and inflammation, which are common important risk factors for increased morbidity and mortality in maintenance hemodialysis (MHD) patients. OBJECTIVE: To determine the MIS and related it to the presence of atherosclerosis, and the morbidity and mortality rate. MATERIAL AND METHOD: The inflammatory and nutritional status in 100 MHD patients was evaluated by serum high-sensitivity C-reactive protein (hs-CRP), Subjective Global Assessment (SGA), and MIS. Atherosclerosis was defined by a history of cardiovascular disease or presence of carotid plaque by B-mode ultrasonography. Twelve-month prospective hospitalization and mortality rates were recorded. RESULTS: The MIS score was significantly higher in patients with atherosclerosis (5.5 +/- 2.3 vs. 3.0 +/- 1.7, p = 0.003) and modestly correlated with serum ferritin level (r = 0.304, p = 0.03), but did not correlated with hs-CRP. The SGA was not associated with hs-CRP level and atherosclerosis. Over a 12-month follow-up period, 4 patients died and 28 were hospitalized at least once. Compared to the survivor group, MIS in the deceased group was significantly higher (8.0 +/- 1.4 vs. 5.1 +/- 2.3, p = 0.01) while SGA, hs-CRP and other biochemical markers were not significantly different. The Receiver Operating Characteristics Curves for the prediction of 1-year mortality from the MIS score identified the optimal cut-off value of 7.5 with sensitivity of 75% and specificity of 88%. There was no association between MIS or SGA and hospitalization. CONCLUSION: MIS is a useful tool for the assessment of malnutrition and inflammatory status. It is superior to the conventional SGA as a predictor of short-term outcome in MHD patients.
Authors:
Chotima Pisetkul; Kullanuch Chanchairujira; Nucharee Chotipanvittayakul; Leena Ong-Ajyooth; Thawee Chanchairujira
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the Medical Association of Thailand = Chotmaihet thangphaet     Volume:  93 Suppl 1     ISSN:  0125-2208     ISO Abbreviation:  J Med Assoc Thai     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-04-06     Completed Date:  2010-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7507216     Medline TA:  J Med Assoc Thai     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  S147-56     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atherosclerosis / complications,  mortality,  ultrasonography*
C-Reactive Protein / analysis
Female
Follow-Up Studies
Hospitalization
Humans
Inflammation / complications,  diagnosis*,  mortality
Kidney Failure, Chronic / complications,  epidemiology,  therapy*
Male
Malnutrition / diagnosis*,  etiology,  mortality
Middle Aged
Morbidity
Nutritional Status
Outcome Assessment (Health Care) / methods*
ROC Curve
Renal Dialysis / adverse effects,  mortality*
Thailand / epidemiology
Chemical
Reg. No./Substance:
9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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