Malnutrition–Inflammation Score of Patients with Chronic Kidney Disease from Early Stage to Initiation of Dialysis

Lim, Lee-Moay; Kuo, Hung-Tien; Chao, Yu-Lin; Shen, Feng-Ching; Chen, Yi-Kong; Chiu, Yi-Wen; Hwang, Shang-Jyh; Hung, Chi-Chih

doi:10.3390/nu16234014

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Malnutrition–Inflammation Score of Patients with Chronic Kidney Disease from Early Stage to Initiation of Dialysis

by

Lee-Moay Lim

^1,2,

Hung-Tien Kuo

^1,2

,

Yu-Lin Chao

¹

,

Feng-Ching Shen

¹

,

Yi-Kong Chen

¹,

Yi-Wen Chiu

^1,2

,

Shang-Jyh Hwang

^1,2

and

Chi-Chih Hung

^1,2,*

¹

Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan

²

School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan

^*

Author to whom correspondence should be addressed.

Nutrients 2024, 16(23), 4014; https://doi.org/10.3390/nu16234014 (registering DOI)

Submission received: 6 October 2024 / Revised: 18 November 2024 / Accepted: 22 November 2024 / Published: 23 November 2024

(This article belongs to the Section Clinical Nutrition)

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Abstract

Background: The malnutrition–inflammation score (MIS) is a practical and accessible tool for evaluating protein energy wasting (PEW) in patients on dialysis. However, the severity of PEW at each stage of chronic kidney disease (CKD), especially with late dialysis initiation, is unclear. Methods: We evaluated the MIS of 3659 patients with CKD stages 1–5 and the changes in their MIS results at baseline and at the time before dialysis initiation. Patients were defined to have PEW if they had a subjective global assessment (SGA) rating of C or lower. Results: The MIS increased substantially over a follow-up period of 6.12 years for 1124 patients just starting dialysis, with 49.3% having an MIS of 8. The pre-dialysis MIS was associated with baseline MIS, age, cardiovascular disease, and cancer. The prevalence of PEW based on an SGA rating of C or lower increased from 10.5% at baseline to 61.2% immediately before dialysis. The prevalence of PEW based on an MIS of ≥8 increased from 28.5% at baseline to 49.3% immediately before dialysis. In CKD stage 5 patients, 29.4% had PEW based on an MIS of 8 or less, and 11.6% had an SGA rating of C. The MIS was revealed to be associated with renal function, nutritional markers, and cardiometabolic disease (diabetes or cardiovascular disease). Conclusions: In conclusion, the MIS increased as CKD progressed to stages 4 and 5, as well as just prior to dialysis. Our study identified patients who required PEW assessment on the basis of their MIS results.

Keywords: chronic kidney disease (CKD); malnutrition–inflammation score (MIS); protein energy wasting (PEW); nutritional assessment; dialysis

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MDPI and ACS Style

Lim, L.-M.; Kuo, H.-T.; Chao, Y.-L.; Shen, F.-C.; Chen, Y.-K.; Chiu, Y.-W.; Hwang, S.-J.; Hung, C.-C. Malnutrition–Inflammation Score of Patients with Chronic Kidney Disease from Early Stage to Initiation of Dialysis. Nutrients 2024, 16, 4014. https://doi.org/10.3390/nu16234014

AMA Style

Lim L-M, Kuo H-T, Chao Y-L, Shen F-C, Chen Y-K, Chiu Y-W, Hwang S-J, Hung C-C. Malnutrition–Inflammation Score of Patients with Chronic Kidney Disease from Early Stage to Initiation of Dialysis. Nutrients. 2024; 16(23):4014. https://doi.org/10.3390/nu16234014

Chicago/Turabian Style

Lim, Lee-Moay, Hung-Tien Kuo, Yu-Lin Chao, Feng-Ching Shen, Yi-Kong Chen, Yi-Wen Chiu, Shang-Jyh Hwang, and Chi-Chih Hung. 2024. "Malnutrition–Inflammation Score of Patients with Chronic Kidney Disease from Early Stage to Initiation of Dialysis" Nutrients 16, no. 23: 4014. https://doi.org/10.3390/nu16234014

APA Style

Lim, L. -M., Kuo, H. -T., Chao, Y. -L., Shen, F. -C., Chen, Y. -K., Chiu, Y. -W., Hwang, S. -J., & Hung, C. -C. (2024). Malnutrition–Inflammation Score of Patients with Chronic Kidney Disease from Early Stage to Initiation of Dialysis. Nutrients, 16(23), 4014. https://doi.org/10.3390/nu16234014

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Malnutrition–Inflammation Score of Patients with Chronic Kidney Disease from Early Stage to Initiation of Dialysis

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