title: The predictive value of malnutrition - inflammation score on 1-year mortality in Turkish maintenance hemodialysis patients.
abstract: OBJECTIVE
  The aim of this study was to evaluate the predictive value of malnutrition-inflammation score (MIS) on short-term mortality and to identify the best cut-off point in the Turkish maintenance hemodialysis (MHD) population.
  
  
  METHODS
  A total of 100 patients on MHD were included in this prospective single-center study. Demographic, anthropometric, and biochemical data were obtained from all patients. The study population was followed up as a 12-month prospective cohort to evaluate mortality as the primary outcome.
  
  
  RESULTS
  Median (IQR) age and HD vintage of 100 patients (M/F: 52/48) were 53 (39.5 - 67) years and 53.5 (11 - 104.7) months, respectively. Deceased patients (n = 7) had significantly older age (years) (50 (38.5 - 63.5) vs. 70 (62 - 82), respectively, p = 0.001), lower spKt/V (1.60 (1.40 - 1.79) vs. 1.35 (0.90 - 1.50), respectively, p = 0.002), lower triceps skinfold thickness (14 (10 - 19) vs. 9 (7 - 11), respectively, p = 0.021) and higher MIS (5 (4 - 7) vs. 10 (7 - 11), respectively, p = 0.013). In the ROC analysis, we found that the optimal cut-off value of MIS for predicting death was 6.5 with 85.7% sensitivity and 62.4% specificity (positive and negative predictive values were 0.6951 and 0.8136, respectively). Advanced age, low spKt/V, and high MIS were found to be predictors of mortality in multivariate logistic regression analysis. The 1-year mortality rate was significantly higher in MIS > 6.5 group compared to the MIS ≤ 6.5 group (14,3% (6/41) vs. 1.6% (1/59), respectively). Compared to MIS ≤ 6.5 group, 1 year survival time of the patients with MIS > 6.5 was found to be significantly lower (47.8 ± 0.16 vs. 43.6 ± 1.63 weeks, respectively, p (log-rank) = 0.012).
  
  
  CONCLUSIONS
  MIS is a robust and independent predictor of short-term mortality in MHD patients. Patients with MIS > 6.5 had a significant risk, and additional risk factors associated with short-term mortality were advanced age and low spKt/V.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Kara
authors.forename: Tuncay
authors.initials: T
authors.lastname: Sahutoglu
authors.forename: Elbis
authors.initials: E
authors.lastname: Ahbap
authors.forename: Tamer
authors.initials: T
authors.lastname: Sakaci
authors.forename: Yener
authors.initials: Y
authors.lastname: Koc
authors.forename: Taner
authors.initials: T
authors.lastname: Basturk
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sevinc
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Akgol
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Unsal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000453:epidemiology* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014421:Turkey / Q000453:epidemiology