Malnutrition-inflammation score and quality of life in hemodialysis patients: is there any correlation?

Background: Malnutrition, inflammation and poor quality of life are prevalent among hemodialysis (HD) patients. Health-related quality of life is an important determinant of hospitalization and mortality in HD patients.

Objectives: The aim of this study was to assess the correlation between quality of life and malnutrition-inflammation status according to subjective global assessment (SGA) and malnutrition-inflammation scores (MIS) in HD patients.

Patients And Methods: We randomly selected 87 of 180 stable HD patients from two HD centers. Those on hemodialysis for at least three months and with malnutrition according to the SGA scores were included in this study. They were divided into two groups of mild to moderate malnutrition (n = 39) and severe malnutrition (n = 49) based on the SGA scores. Serum levels of transferrin, albumin, blood urea nitrogen, creatinine, kt/v, body mass index and malnutrition-inflammation scores were measured in all patients. Health-related quality of life was assessed by validated short form-12 (SF-12) questionnaire for each patient. These values were compared between the two groups of patients by independent sample t-test and Mann-Whitney U test. The correlations of nutritional variables with SGA and MIS scores were determined by Pearson and Spearman correlation tests.

Results: There were no differences in measured parameters between the two groups except for MIS scores. Those with severe malnutrition showed higher MIS scores. All quality of life aspects and total scores (PCS, MCS) (rather than social functioning (SF) aspect) were significantly different between the two groups, which showed lower physical and mental scores in severely-malnourished patients. Physical functioning (PF), role limitations due to physical heath (RP), general health (GH), mental health (MH), SF, role limitation due to emotional health (RE), vitality (VT) aspects and total scores (PCS and MCS) had negative significant correlations with MIS and SGA scores (All P values < 0.05). No correlation was found between MIS and SGA scores and other measured variables.

Conclusions: This study focused on important effects of malnutrition and inflammation on health-related quality of life aspects, both physically and mentally in HD patients. SGA and MIS are highly correlated with quality of life in HD patients.