Department of Nephrology, Baskent University Hospital, Ankara, Turkey.
Perit Dial Int. 2006 Nov-Dec;26(6):705-11.
Malnutrition-Inflammation Score (MIS) is a quantitative assessment tool based on Subjective Global Assessment (SGA) and predicts mortality and morbidity in maintenance hemodialysis patients. However, there are not enough data about the use of MIS in peritoneal dialysis (PD). In this study, relationships between MIS and prospective hospitalization indices, risk of developing peritonitis, anemia indices, and laboratory and anthropometric parameters were analyzed and compared with SGA in PD.
50 PD patients (M/F 26/24, age 45.2 +/- 14.9 years, mean PD duration 30.8 +/- 23.1 months) were included. The same physician performed the SGA and MIS evaluations. Clinical, laboratory, and anthropometric parameters were measured.
18 patients were classified as SGA-A (without malnutrition), 24 as SGA-B (with moderate malnutrition), and 8 as SGA-C (with severe malnutrition). Increment in MIS was concordant with SGA groups A to C (p < 0.0001). Peritonitis rate, number of hospitalizations, total number of hospitalization days, erythropoietin requirements, C-reactive protein (CRP), and ferritin levels were positively correlated with MIS (p < 0.0001). Midarm muscle circumference (p = 0.04), albumin (p < 0.0001), prealbumin (p = 0.001), creatinine (p = 0.04), hemoglobin (p = 0.003), transferrin (p < 0.0001), and cholesterol (p = 0.009) were negatively correlated with MIS. Correlation coefficients of hospitalization indices, peritonitis rate, anemia indices, erythropoietin requirements, albumin, prealbumin, CRP, and anthropometric parameters were higher with MIS than with SGA. In logistic regression analysis, a higher MIS was independently associated with a higher risk of future hospitalization (p = 0.029, odds ratio 2.14, confidence interval 1.082-4.146).
This study demonstrated that MIS significantly correlated with clinical, nutritional, inflammatory, and anthropometric parameters and anemia indices in PD patients, and that those correlations were stronger than those with SGA.
营养不良-炎症评分（MIS）是一种基于主观全面评估（SGA）的定量评估工具，可预测维持性血液透析患者的死亡率和发病率。然而，关于 MIS 在腹膜透析（PD）中的应用的数据还不够充分。在这项研究中，分析了 MIS 与前瞻性住院指标、腹膜炎发生风险、贫血指标以及实验室和人体测量参数之间的关系，并与 PD 中的 SGA 进行了比较。
纳入 50 例 PD 患者（男/女 26/24 例，年龄 45.2±14.9 岁，平均 PD 持续时间 30.8±23.1 个月）。由同一位医生进行 SGA 和 MIS 评估。测量临床、实验室和人体测量参数。
18 例患者被归类为 SGA-A（无营养不良），24 例患者为 SGA-B（中度营养不良），8 例患者为 SGA-C（重度营养不良）。MIS 的增加与 SGA 组 A 至 C 一致（p<0.0001）。腹膜炎发生率、住院次数、总住院天数、促红细胞生成素需求、C 反应蛋白（CRP）和铁蛋白水平与 MIS 呈正相关（p<0.0001）。上臂中部肌肉围度（p=0.04）、白蛋白（p<0.0001）、前白蛋白（p=0.001）、肌酐（p=0.04）、血红蛋白（p=0.003）、转铁蛋白（p<0.0001）和胆固醇（p=0.009）与 MIS 呈负相关。住院指数、腹膜炎发生率、贫血指标、促红细胞生成素需求、白蛋白、前白蛋白、CRP 和人体测量参数的相关性系数与 MIS 比 SGA 更高。在逻辑回归分析中，较高的 MIS 与未来住院的更高风险独立相关（p=0.029，优势比 2.14，95%置信区间 1.082-4.146）。
本研究表明，MIS 与 PD 患者的临床、营养、炎症和人体测量参数以及贫血指标显著相关，且与 SGA 相比，这些相关性更强。
