Evaluation of the prognostic significance of the malnutrition inflammation score in hemodialysis patients.

Background & Aims: To verify the performance of Malnutrition Inflammation Score (MIS) in the evaluation of nutritional status and its relation with clinical outcomes.

Methods: Nutritional status was evaluated by MIS. The Mann Whitney and chi-square tests were used to compare the dependent variables MIS, death, and hospitalization. We used the forward stepwise multivariate regression model to evaluate the relationship between age, dialysis time, albumin, total iron binding capacity, C-reactive protein (CRP), and ferritin and the outcome variables. The Kaplan-Meier curve was constructed to evaluate the influence of MIS on survival in the two groups of patients, and log rank tests were used to ascertain the equality of survival distributions in these groups. ROC curves were fitted to measure the area under the curve and the significance of MIS in predicting mortality.

Results: A total of 47 patients on hemodialysis with a median age of 62 (48.5-72) took part in this study. The median total MIS was 9 (5.5-10). The MIS of 51% of the patients indicated they were malnourished. After 29 months' follow-up, 27.7% of the patients had died and survival was significantly lower in the high MIS group. The score from Part B of the MIS form and ferritin were higher for the patients who deceased during the follow-up period. Patients with an MIS >9 presented a significantly shorter survival time than those with an MIS ≤9.

Conclusion: MIS is effective in evaluating the nutritional status of patients on hemodialysis and has a predictive capacity for negative clinical outcomes.