SO045DOES MALNUTRITION INFLAMMATION SCORE MAINTAINS ITS PREDICTIVE RISK ASSESSMENT IN THE MODERN HEMODIALYSIS ERA?. (6th June 2020)

• Record Type: Journal Article
• Authors: Sá Martins, Vitor; Adragao, Teresa; Aguiar, Leila; Dias, Catarina; Lourenço, Pedro; Figueiredo, Rita; Pascoal, Tania; Pereira, Juliana; Pinheiro, Tatiana; Ramião, Inês; Velez, Brígida; Papoila, Ana Luisa; Pinto, Iola; Borges, Nuno; Calhau, Conceição; Macário, Fernando
• Is Part Of: Nephrology dialysis transplantation. Volume 35(2020)Supplement 3
• Publication Date: 2020-06-06
• Subjects: Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfaa139.SO045
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background and Aims: Malnutrition Inflammation score (MIS) is a risk score published in 2001 (Kalantar-Zadeh, 2001) and validated in 2008 (Rambod, 2009). It is associated with a high mortality and morbidity risk in hemodialysis (HD) patients (pts). Currently, HD pts population is composed of much older individuals, submitted to a high efficient treatment with access to pharmacological and nutritional therapy, assured by a bundled payment, when comparing with the validation study population. The objective of this study is to evaluate if MIS maintain its predictive risk assessment. Method: Cross sectional analysis of HD pts from 25 outpatient clinics. MIS was evaluated at the study baseline. Univariable and multivariable Cox additive regression models were used to analyze the data. C-index was estimated to assess the performance of the final model. A level of significance of α= 0.05 was considered. Results: A total of 2444 pts were analyzed (59.0% males; 32.0% diabetic) during a median period of 48 months (P25 =31; P75 =48), 875 patients registered MIS<5, corresponding to 35.8%. All-cause mortality was observed in 860 pts (35.2%). There were 202 (35.8%) events in the group of patients with MIS<5, while in the group with MIS≥5, the number of deaths was higher (658 pts, 41.9%). In univariable analysis using Cox additive model, the main results were: In multivariable analysis, adjusting for age, nPNA, IDWG, Kt/V and diabetes, a MIS ≥ 5 and ≥ 7 showed, respectively, a HR of 1.761 (IC 95%, p<0.001) and 1.822 (IC 95%, p<0.001). Conclusion: The findings of this analysis confirms that MIS maintains a discriminative power to identify higher risk of mortality. In this model, age and diabetes also correlate with mortality risk increase, while nPNA, IDWG and Kt/V have the opposite effect.