Assessment of Malnutrition Inflammation Score in Different Stages of Chronic Kidney Disease

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Abstract

Background: Protein-energy wasting (PEW) is common in patients with chronic kidney disease (CKD), and is associated with high morbidity and mortality. Malnutrition-Inflammation Score (MIS) has significant correlations with prospective hospitalization and mortality, as well as measures of anemia, inflammation, and nutrition in dialysis patients.

Material and Methods: The study was conducted on 100 adult patients of CKD selected from K&D clinic PGIMS, Rohtak. All the patients went under detailed socioeconomic, clinical, biochemical and radiological examination. The average of three measurements of body weight, height, triceps skin fold thickness (TST), and mid-arm muscle circumference (MAMC) were measured in all patients. MIS was calculated for all the patients.

Results: Out of total 100 patients, 64 were male and 36 were female. Overall, the prevalence of malnutrition was 60%. A total of 42%, 16% and 2% patients had mild, moderate and severe malnutrition respectively. Our study also shows significant association between staging of CKD (3 to 5-D) and MIS. A significant negative correlation was found between MIS and factors such as BMI, eGFR, serum calcium and hemoglobin levels. A significant positive correlation of this score was found with blood urea serum creatinine, serum uric acid, serum potassium and serum phosphate. Multivariate analysis showed significant association between MIS and serum albumin, TIBC, BMI, family income and hs-CRP.

Conclusion: Assessment of key components of malnutrition and inflammation early in disease course will help to identify high risk subjects in whom modifying these predictors will help in providing active and healthy life for CKD patients.

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