Korean J Med.  2006 Dec;71(6):635-645.

Relationship of malnutrition-inflammation score with atherosclerosis in maintenance hemodialysis patients

Affiliations
  • 1Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. kyubeck.lee@samsung.com
  • 2Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Nutrition, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND: Malnutrition-inflammation complex syndrome (MICS) is common in maintenance hemodialysis (MHD) patients and may be related to a poor outcome. However, there is little evidence showing MICS to be a risk factor for atherosclerosis. The aim of this study was to determine if MICS is associated with the atherosclerotic markers such as abdominal aortic calcification (AAC) and pulse wave velocity (PWV) in MHD patients.
METHODS
Eighty MHD patients were selected in Kangbuk Samsung Hospital (male: female=50:30, age 58+/-14 years). The nutritional status was assessed by the Subjective Global Assessment (SGA), biochemical measurement and the normalized protein equivalent of the total nitrogen appearance (nPNA). The presence of inflammatory reaction was assessed by the C-reactive protein (CRP). The malnutrition-Inflammation Score (MIS) was used to assess MICS. A lateral lumbar radiogram was used to evaluate the AAC index. Brachial-ankle (ba) PWV using automatic device was performed.
RESULTS
Malnourished patients had a higher MIS than the well nourished patients (8.7+/-3.6 vs. 4.0+/-1.8, p<0.001). Patients with inflammation (CRP3 mg/L) showed a higher MIS than patients without inflammation (7.6+/-4.6 vs. 5.7+/-3.3, p=0.045). There was no correlation between the MIS and the AAC index (r=0.157, p=0.191) and baPWV (r= 0.144, p=0.323).
CONCLUSION
These results suggest that the MIS is a useful marker of MICS in MHD patients. However, the MIS was not directly related to the AAC index and baPWV. This report highlights the importance of assessing the MICS and atherosclerosis in MHD patients.

Keyword

Hemodialysis; Malnutrition; Inflammation; Arteriosclerosis and Pulse wave velocity

MeSH Terms

Atherosclerosis*
C-Reactive Protein
Humans
Inflammation
Malnutrition
Nitrogen
Nutritional Status
Pulse Wave Analysis
Renal Dialysis*
Risk Factors
C-Reactive Protein
Nitrogen
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