Assessment of the reliability and consistency of the "malnutrition inflammation score" (MIS) in Mexican adults with chronic kidney disease for diagnosis of protein-energy wasting syndrome (PEW).
BACKGROUND
The protein-energy wasting syndrome (PEW) is a condition of malnutrition, inflammation, anorexia and wasting of body reserves resulting from inflammatory and non-inflammatory conditions in patients with chronic kidney disease (CKD).One way of assessing PEW, extensively described in the literature, is using the Malnutrition Inflammation Score (MIS).


OBJECTIVE
To assess the reliability and consistency of MIS for diagnosis of PEW in Mexican adults with CKD on hemodialysis (HD).


METHODS
Study of diagnostic tests. A sample of 45 adults with CKD on HD were analyzed during the period June-July 2014.The instrument was applied on 2 occasions; the test-retest reliability was calculated using the Intraclass Correlation Coefficient (ICC); the internal consistency of the questionnaire was analyzed using Cronbach's αcoefficient. A weighted Kappa test was used to estimate the validity of the instrument; the result was subsequently compared with the Bilbrey nutritional index (BNI).


RESULTS
The reliability of the questionnaires, evaluated in the patient sample, was ICC=0.829.The agreement between MIS observations was considered adequate, k= 0.585 (p <0.001); when comparing it with BNI, a value of k = 0.114 was obtained (p <0.001).In order to estimate the tendency, a correlation test was performed. The r² correlation coefficient was 0.488 (P <0.001).


CONCLUSIONS
MIS has adequate reliability and validity for diagnosing PEW in the population with chronic kidney disease on HD.
Fac. de Medicina, Universidad Nacional Autónoma de México. Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. ailejgo@gmail.com.
Ailema Janeth
AJ
González-Ortiz
Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. celenestrella@hotmail.com.
Celene Viridiana
CV
Arce-Santander
Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. olynkavega@gmail.com.
Olynka
O
Vega-Vega
Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. correarotter@prodigy.net.mx.
Ricardo
R
Correa-Rotter
Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Atención a la Salud, Universidad Autónoma Metropolitana-Xochimilco, México DF. México.. angeles.espinosac@quetzal.innsz.mx.
María de Los Angeles
Mde L
Espinosa-Cuevas
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000855:Anorexia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D000886:Anthropometry; D001835:Body Weight; D015897:Comorbidity; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D007501:Iron / Q000097:blood; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015596:Nutrition Assessment; D011502:Protein-Energy Malnutrition / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014168:Transferrin / Q000032:analysis; D019282:Wasting Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology
D012709:Serum Albumin; D014168:Transferrin; D007501:Iron