Bavi Behbahani Hossein, Alipour Meysam, Zare Javid Ahmad, Razmi Hamidreza, Tofighzadeh Pardis, Fayazfar Fatemeh, Keramatzadeh Sara, Shokri Shiva, Soltaniyan Dehkordi Haleh, Khosravi Kian, Babajafari Esfandabad Siavash, Shayanpour Shokouh
Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran.
Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, P. O. Box: 15794-61375, Ahvaz, Iran.
Sci Rep. 2024 Dec 30;14(1):31811. doi: 10.1038/s41598-024-83100-4.
Malnutrition is prevalent among hemodialysis patients, negatively impacting their quality of life (QoL) and chronic kidney disease-associated pruritus (CKD-aP). This study investigates the association between the Malnutrition-Inflammation Score (MIS) and CKD-aP, as well as QoL, in hemodialysis patients. This cross-sectional study was conducted on 479 HD patients (279 males and 200 females) referred to eight dialysis centers. A food frequency questionnaire (FFQ), Kidney Disease Quality of Life Short Form (KDQOL-SF™), and Yosipovitch Itch Questionnaire (YIQ) were used to assess nutritional status, QoL, and CKD-aP, respectively. Anthropometric indices, body mass index (BMI), biochemical parameters, and adequacy of dialysis (Kt/V) were also measured in all patients. Significant differences were observed across MIS quartiles in terms of age, dialysis vintage, dialysis time, and urine volume (p < 0.05 for all). QoL scores showed significant differences, with the physical component score and symptoms/problems score being lower in higher MIS quartiles (p < 0.05 for all). Multivariate analyses revealed that higher MIS quartiles were significantly associated with worse QoL scores, including symptoms/problems and physical component scores, even after adjusting for confounders (p < 0.05 for all). Moreover, the pruritus VAS score, as well as the burden of kidney disease and mental component, had a significant negative association with MIS after adjusting for confounders (p < 0.05 for all). This study demonstrates that higher MIS, indicating poorer nutritional status, is associated with impaired QoL, particularly in the symptoms/problems, physical, and mental components among hemodialysis patients. However, no significant association was found between MIS and CKD-aP.
营养不良在血液透析患者中普遍存在，对他们的生活质量（QoL）和慢性肾脏病相关瘙痒（CKD-aP）产生负面影响。本研究调查血液透析患者中营养不良-炎症评分（MIS）与CKD-aP以及QoL之间的关联。这项横断面研究对转诊至八个透析中心的479例血液透析患者（279例男性和200例女性）进行。分别使用食物频率问卷（FFQ）、肾脏病生活质量简表（KDQOL-SF™）和约西波维奇瘙痒问卷（YIQ）来评估营养状况、QoL和CKD-aP。还测量了所有患者的人体测量指标、体重指数（BMI）、生化参数和透析充分性（Kt/V）。在年龄、透析龄、透析时间和尿量方面，各MIS四分位数之间存在显著差异（所有p<0.05）。QoL评分存在显著差异，较高MIS四分位数中的身体成分评分和症状/问题评分较低（所有p<0.05）。多变量分析显示，即使在调整混杂因素后，较高的MIS四分位数仍与较差的QoL评分显著相关，包括症状/问题评分和身体成分评分（所有p<0.05）。此外，在调整混杂因素后，瘙痒视觉模拟评分（VAS）以及肾脏病负担和心理成分与MIS存在显著负相关（所有p<0.05）。本研究表明，较高的MIS表明营养状况较差，与QoL受损相关，尤其是血液透析患者的症状/问题、身体和心理成分方面。然而，未发现MIS与CKD-aP之间存在显著关联。
