Malnutrition–Inflammation Score is a Useful Tool in Peritoneal Dialysis Patients

2006 ◽  
Vol 26 (6) ◽  
pp. 705-711 ◽  
Author(s):  
Bariş Afşar ◽  
Siren Sezer ◽  
Fatma Nurhan Ozdemir ◽  
Huseyin Celik ◽  
Rengin Elsurer ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Assessment Tool ◽  
Clinical Laboratory ◽  
Correlation Coefficients ◽  
Severe Malnutrition ◽  
Maintenance Hemodialysis ◽  
Anthropometric Parameters ◽  
Mortality And Morbidity ◽  
Moderate Malnutrition ◽  
Inflammation Score

Background 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. Methods 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. Results 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). Conclusions 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.

scholarly journals Nutritional Status of Patients on Maintenance Hemodialysis in a Tertiary Referral Hospital of Nepal

2017 ◽  
Vol 15 (2) ◽  
pp. 40-47
Author(s):  
Abhishek Maskey ◽  
Yukta Narayan Regmi ◽  
Sushant Katuwal
Keyword(s):  
Nutritional Status ◽  
Nutritional Assessment ◽  
Referral Hospital ◽  
Maintenance Hemodialysis ◽  
Tertiary Referral ◽  
Anthropometric Parameters ◽  
Tertiary Referral Hospital ◽  
Mortality And Morbidity ◽  
Skin Fold Thickness ◽  
Moderate Malnutrition

Introduction: Malnutrition is a common problem in hemodialysis patient, which is associated with increased mortality and morbidity. There is paucity of data regarding the nutritional status of patient on maintenance hemodialysis in developing countries. This study attempts to access nutritional status of patients on hemodialysis in tertiary referral hospital on western region of Nepal and correlate it with biochemical and laboratory parameters.Methods: A total of fifty patients on hemodialysis were evaluated. Nutritional assessment was made by Subjective Global Assessment (SGA) score, anthropometrics [Body Mass Index (BMI), Triceps Skin Fold Thickness (TSF), Mid Arm Circumference (MAC), Mid Arm Muscle Circumference (MAMC) and biochemical tests.Results: The study assessed 50 patients (34 males and 16 females) with mean age of 54 ± 14 years. Seventy eight percent (39) patients had mild to moderate malnutrition. Anthropometric parameters like BMI, TSF, MAC with normal nutrition were significantly higher than in patients with mild to moderate malnutrition. Malnutrition score (MS) by SGA significantly correlated with duration of dialysis. However, serum albumin was not statistically significant.Conclusion: Malnutrition is very common in patients undergoing hemodialysis with SGA having significant correlation with duration of dialysis. Routine nutritional monitoring among such patients are extremely important for diagnosing malnutrition early on, thus preventing complications and reducing the morbidity and mortality rates in this population.  

scholarly journals Etiologic-sociodemographic assessment and comparison of dialysis modalities in pediatric Syrian migrants with chronic kidney disease

2021 ◽  
Author(s):  
Mehtap Çelakıl ◽  
Yasemin Çoban
Keyword(s):  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Clinical Laboratory ◽  
Kidney Diseases ◽  
Pediatric Nephrology ◽  
Refugee Children ◽  
Mortality And Morbidity ◽  
Ventricle Hypertrophy ◽  
Hospital Pediatric

Abstract Background: Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are among the important causes of mortality and morbidity in childhood. Early diagnosis and treatment of the underlying primary disease may prevent most of CKD patients from progressing to ESRD. There is no study examining chronic kidney diseases and dialysis modalities in Syrian immigrant children. We aimed to retrospectively research the etiologic, sociodemographic, and clinical factors in CKD among Syrian refugee children, and at the same time, to compare the clinical characteristics of patients with ESRD on peritoneal dialysis and hemodialysis. Methods: Our study included a total of 79 pediatric Syrian patients aged from 2-16 years monitored at Hatay State Hospital pediatric nephrology clinic with diagnosis of various stages of CKD and with ESRD. Physical-demographic features and clinical-laboratory information were retrospectively screened. Results: The most common cause of CKD was congenital anomalies of the kidneys and urinary tracts (CAKUT) (37.9%). Other causes were urolitiasis (15.1%), nephrotic syndrome (10.1%), spina bifida (8.8%), hemolytic uremic syndrome (7.5%), and glomerulonephritis (7.5%). Twenty-five patients used hemodialysis due to bad living conditions. Only 2 of the patients with peritoneal dialysis were using automatic peritoneal dialysis (APD), with 5 using continuous ambulatory peritoneal dialysis (CAPD). Long-term complications like left ventricle hypertrophy and retinopathy were significantly higher among hemodialysis patients. There was no difference identified between the groups in terms of hypertension and sex. Conclusion: Progression to ESRD due to preventable reasons is very frequent among CKD patients. For more effective use of peritoneal dialysis in pediatric patients, the responsibility of states must be improved.

Anemia is Correlated with Malnutrition and Inflammation in Croatian Peritoneal Dialysis Patients: A Multicenter Nationwide Study

2017 ◽  
Vol 37 (4) ◽  
pp. 472-475 ◽  
Author(s):  
Josipa Radić ◽  
Nikolina Bašic-Jukić ◽  
Božidar Vujicić ◽  
Dragan Klarić ◽  
Goran Radulović ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Clinical Laboratory ◽  
Binding Capacity ◽  
Albumin Level ◽  
Weekly Dose ◽  
Anthropometric Parameters ◽  
Reactive Protein ◽  
Anemia Management

Malnutrition, inflammation, and anemia are common in peritoneal dialysis (PD) patients. In this study, correlations between Malnutrition Inflammation Score (MIS), laboratory and anthropometric parameters, and anemia indices in Croatian PD patients were analyzed. One hundred and one PD patients (males/females 54/47, age 58.71 ± 14.68 years, mean PD duration 21.82 ± 21.71 months) were included. Clinical, laboratory, and anthropometric parameters were measured. Statistically significant correlations between MIS and erythropoietin weekly dose per kg of body weight (ESA weekly dose), hemoglobin (Hb), and erythrocytes were found ( r = 0.439, p < 0.001; r = -0.032, p < 0.001; r = -0.435, p < 0.001), respectively. Also, statistically significant correlations were found between MIS and mean corpuscular volume ( r = 0.344, p < 0.001), iron ( r = -0.229, p = 0.021), and total iron binding capacity (TIBC) ( r = -0.362, p < 0.001), respectively. Furthermore, statistically significant correlations between ESA weekly dose and serum albumin level and body mass index (BMI) were found ( r = -0.272, p = 0.006; r = -0.269, p = 0.006), respectively. When we divided PD patients into 2 groups according Hb level (Hb ≥ 11 0 [ N = 60, 59.41 %]) and Hb < 110 [ N = 41, 40.59%]), statistically significant differences were found in MIS score (3.02 ± 2.54 vs 4.54 ± 3.54, p = 0.014), C-reactive protein (CRP) (3.52 ± 6.36 vs 7.85 ± 7.96, p = 0.005), and serum albumin level (44.22 ± 8.54 vs 39.94 ± 8.56, p = 0.003), respectively. Our findings suggest that anemia is correlated with malnutrition and inflammation in Croatian PD patients. Further studies are needed to assess whether modulating inflammatory or nutritional processes can improve anemia management in PD patients.

Validity of Thai Nutritional Assessment Form and Nutrition Triage 2013 to Diagnose Malnutrition in Non-Dialytic Chronic Kidney Disease

2021 ◽  
Vol 104 (11) ◽  
pp. 1801-1806
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Assessment Tool ◽  
Nutritional Assessment ◽  
High Sensitivity ◽  
Assessment Tools ◽  
Severe Malnutrition ◽  
Kappa Statistics ◽  
Cross Sectional ◽  
Inflammation Score

Background: Malnutrition inflammation score (MIS) is a universal tool to assess the presence of malnutrition among patients with chronic kidney disease (CKD). An appropriate diagnosis coding for malnutrition affects hospital reimbursement in Thailand. The Nutrition Alert Form (NAF) and the Nutritional Triage (NT-2013) have been approved as standard nutrition assessment tools for general populations. Objective: To study the validity of the NAF and the NT-2013 among patients with MIS at non-dialytic CKD stages 3 to 5. Materials and Methods: A cross-sectional study was conducted among the patients with non-dialytic CKD stages 3 to 5. NAF, NT-2013, and MIS nutritional assessment tools were performed in all subjects. Cohen’s kappa statistics and Pearson’s correlation were used to determine the validity of NAF and NT-2013. Results: Two hundred seven participants were included in the present study. According to the MIS assessment classification, normal to mild, moderate, and severe malnutrition were diagnosed in 59.9%, 34.8%, and 5.3%, respectively. The correlation between NAF and NT-2013 when compared with MIS were r=0.619 and r=0.689 (p<0.001), respectively. The sensitivity, specificity, and area under receiver operating characteristic (ROC) curve of assessment score to diagnose moderate to severe malnutrition were 47.6, 75.9, and 0.698 (95% CI 0.628 to 0.768) in NAF score greater than 5, and 100, 3.6, and 0.707 (95% CI 0.637 to 0.777) in NT-2013 score greater than 7, respectively. Conclusion: Among patients with CKD stages 3 to 5, the nutritional assessment tool NAF and NT-2013 correlated well with MIS. It seemed that NAF score is an alternative nutritional assessment tool with moderate sensitivity and specificity test, and NT-2013 score is suitable for a screening nutritional assessments tool to identify malnutrition with high sensitivity but very low specificity in a CKD population. Keywords: Nutritional assessment form (NAF); Nutritional Triage 2013 (NT-2013); Malnutrition inflammation score (MIS); Chronic kidney disease

scholarly journals Nutritional Status of Children Seeking Medical Treatment in a Rural Hospital in Ilam District, Nepal

2015 ◽  
Vol 34 (3) ◽  
pp. 215-220
Author(s):  
C Paneru ◽  
SM George
Keyword(s):  
Nutritional Status ◽  
Community Hospital ◽  
Severe Malnutrition ◽  
National Data ◽  
Mortality And Morbidity ◽  
Severe Stunting ◽  
Under Five ◽  
Childhood Malnutrition ◽  
Moderate Malnutrition ◽  
Nutritional Status Of Children

Introduction: Childhood malnutrition is a leading cause of mortality and morbidity in children under five years in Nepal. There is evidence to show that childhood malnutrition varies from region to region, within Nepal. But there is no data available about nutritional status of children in the 75 districts in Nepal. The aim of this study was to evaluate the nutritional status of children less than five years of age in Ilam district. Material and Methods: We analysed the anthropometric data for the children of Ilam district who visited Dr. Megh Bahadur Parajuli Community Hospital in Ilam district. Results: Our data showed that 15.7% of girls and 21.2% of boys under-five years suffered from moderate malnutrition. Severe malnutrition was present in 6.7% of girls and 9.6% of boys. Stunting was seen in 32.6% girls and 30.16% boys. Moderate stunting was present in 19.6% of girls and 19% of boys; while severe stunting was present in 11% of the boys and 13% of the girls. Conclusion: Our data shows that stunting among under-fives in Ilam is less as compared to that reported for Nepal, but underweight is comparable to the national data. However, a systematic study needs to be carried out in Ilam before drawing firm conclusions. J Nepal Paediatr Soc 2014;34(3):207-215-220 DOI: http://dx.doi.org/10.3126/jnps.v34i3.10737

Predictors of Faster Decline of Residual Renal Function in Taiwanese Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 191-195 ◽  
Author(s):  
Chia-Te Liao ◽  
Chih-Chung Shiao ◽  
Jenq-Wen Huang ◽  
Kuan-Yu Hung ◽  
Hsueh-Fang Chuang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Clinical Laboratory ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Residual Renal Function ◽  
Measure Data ◽  
Chi Square ◽  
Artery Disease

⋄ Objective Loss of residual renal function (RRF) in peritoneal dialysis (PD) patients is a powerful predictor of mortality. The present study was conducted to determine the predictors of faster decline of RRF in PD patients in Taiwan. ⋄ Methods The study enrolled 270 patients starting PD between January 1996 and December 2005 in a single hospital in Taiwan. We calculated RRF as the mean of the sum of 24-hour urea and creatinine clearance. The slope of the decline of residual glomerular filtration rate (GFR) was the main outcome measure. Data on demographic, clinical, laboratory, and treatment parameters; episodes of peritonitis; and hypotensive events were analyzed by Student t-test, Mann–Whitney U-test, and chi-square, as appropriate. All variables with statistical significance were included in a multivariate linear regression model to select the best predictors ( p < 0.05) for faster decline of residual GFR. ⋄ Results All patients commencing PD during the study period were followed for 39.4 ± 24.0 months (median: 35.5 months). The average annual rate of decline of residual GFR was 1.377 ± 1.47 mL/min/m2. On multivariate analysis, presence of diabetes mellitus ( p < 0.001), higher baseline residual GFR ( p < 0.001), hypotensive events ( p = 0.001), use of diuretics ( p = 0.002), and episodes of peritonitis ( p = 0.043) independently predicted faster decline of residual GFR. Male sex, old age, larger body mass index, and presence of coronary artery disease or congestive heart failure were also risk factors on univariate analysis. ⋄ Conclusions Our results suggested that diabetes mellitus, higher baseline residual GFR, hypotensive events, and use of diuretics are independently associated with faster decline of residual GFR in PD patients in Taiwan.

scholarly journals POS1391 MEASURING SUBCLINICAL INFLAMMATION IN HAND AND FOREFOOT IN PATIENTS WITH ARTHRALGIA USING 1.5T OR 3.0T MRI: DOES FIELD STRENGTH MATTER?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 978.1-978
Author(s):  
D. Krijbolder ◽  
M. Verstappen ◽  
F. Wouters ◽  
L. R. Lard ◽  
P. D. De Buck ◽  
...  
Keyword(s):  
Field Strength ◽  
Scientific Evidence ◽  
Correlation Coefficients ◽  
Daily Practice ◽  
Scientific Data ◽  
Imaging Features ◽  
Subclinical Inflammation ◽  
The Individual ◽  
3.0T Mri ◽  
Inflammation Score

Background:Magnetic resonance imaging (MRI) of small joints sensitively detects inflammation. MRI-detected subclinical inflammation, and tenosynovitis in particular, has been shown predictive for RA development in patients with arthralgia. These scientific data are mostly acquired on 1.0T-1.5T MRI scanners. However, 3.0T MRI is nowadays increasingly used in practice. Evidence on the comparability of these field strengths is scarce and it has never been studied in arthralgia where subclinical inflammation is subtle. Moreover, comparisons never included tenosynovitis, which is, of all imaging features, the strongest predictor for progression to RA.Objectives:To determine if there is a difference between 1.5T and 3.0T MRI in detecting subclinical inflammation in arthralgia patients.Methods:2968 locations (joints, bones or tendon sheaths) in hands and forefeet of 28 arthralgia patients were imaged on both 1.5T and 3.0T MRI. Two independent readers scored for erosions, osteitis, synovitis (according to RAMRIS) and tenosynovitis (as described by Haavaardsholm et al.). Scores were also summed as total inflammation (osteitis, synovitis and tenosynovitis) and total RAMRIS (erosions, osteitis, synovitis and tenosynovitis) scores. Interreader reliability (comparing both readers) and field strength agreement (comparing 1.5T and 3.0T) was assessed with interclass correlation coefficients (ICCs). Next, field strength agreement was assessed after dichotomization into presence or absence of inflammation. Analyses were performed on patient- and location-level.Results:ICCs between readers were excellent (>0.90). Comparing 1.5 and 3.0T revealed excellent ICCs of 0.90 (95% confidence interval 0.78-0.95) for the total inflammation score and 0.90 (0.78-0.95) for the total RAMRIS score. ICCs for individual inflammation features were: tenosynovitis: 0.87 (0.74-0.94), synovitis 0.65 (0.24-0.84) and osteitis 0.96 (0.91-0.98). The field strength agreement on dichotomized scores was 83% for the total inflammation score and 89% for the total RAMRIS score. Of the individual features, agreement for tenosynovitis was the highest (89%). Analyses on location- level showed similar results.Conclusion:Agreement of subclinical inflammation scores on 1.5T and 3.0T were good to excellent, in particular for tenosynovitis. This suggests that scientific evidence on predictive power of MRI in arthralgia patients, obtained on 1.5T, can be generalized to 3.0T when this field strength would be used for diagnostic purposes in daily practice.Disclosure of Interests:None declared

Overview of blood purification in uremia

1980 ◽  
Vol 3 (4) ◽  
pp. 203-208
Author(s):  
B.T. Burton
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Rejection Rate ◽  
Blood Purification ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Transplant Patients ◽  
Maintenance Dialysis ◽  
Transplanted Kidneys

Today, management of irreversible renal failure is based primarily on maintenance hemodialysis and renal transplantation with a growing minority of patients treated by peritoneal dialysis. With regard to renal transplantation — the early promise of renal transplantation in the mid 1960's has given way to the realities of the late 1970's. There have been no major changes in the rejection rate of transplanted kidneys in recent years though today's mortality of transplant patients is considerably reduced over what it used to be. Moreover, universally the lack of availability of a sufficient number of organs for transplantation poses a formidable problem. It is all too apparent that current methods of blood purification in uremia are far from optimal. Even though the mortality in maintenance dialysis is relatively low, hemodialysis is characterized by a variety of complications and most maintenance dialysis patients are not optimally rehabilitated.

scholarly journals Relationship between Vascular Calcification, Protein-Energy Wasting Syndrome, and Sarcopenia in Maintenance Automated Peritoneal Dialysis

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 666
Author(s):  
Gustavo Leal-Alegre ◽  
Claudia Lerma ◽  
Gabriela Leal-Escobar ◽  
Bernardo Moguel-González ◽  
Karen Belén Martínez-Vázquez ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Peritoneal Dialysis ◽  
Vascular Calcification ◽  
Automated Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Wasting Syndrome ◽  
Protein Energy ◽  
Inflammation Score

Vascular calcifications affect 80% to 90% of chronic kidney disease patients and are a predictive factor of cardiovascular mortality. Sarcopenia and protein-energy wasting syndrome are also associated with mortality. The aim was to assess the relationship between vascular calcification, sarcopenia, and protein-energy wasting syndrome (PEW) in automated peritoneal dialysis patients. Fifty-one maintenance automated peritoneal dialysis patients were included (27 were male, mean age 39 ± 14 years). Vascular calcification was assessed based on abdomen, pelvis, and hand radiographs. Sarcopenia was assessed with bioimpedance analysis and a hand grip strength test. The Malnutrition–Inflammation Score and the presence of PEW were also assessed. Vascular calcification was present in 21 patients (41.2%). Univariate logistic regression analysis showed that age (p = 0.001), Malnutrition–Inflammation Score (p = 0.022), PEW (p = 0.049), sarcopenia (p = 0.048), and diabetes (p = 0.010) were associated with vascular calcification. Multivariate logistic regression analysis showed that age (p = 0.006) was the only variable associated independently with vascular calcification. In conclusion, there is association between vascular calcification, PEW, and sarcopenia in patients with maintenance automated peritoneal dialysis. These associations are not independent of age. This demonstrates the importance of nutritional status in the prevention of vascular calcification.

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