title: Dietary inflammatory index is associated with serum C-reactive protein and protein energy wasting in hemodialysis patients: A cross-sectional study.
abstract: OBJECTIVE
  Malnutrition and inflammation are reported as the most powerful predictors of mortality and morbidity in hemodialysis (HD) patients. Diet has a key role in modulating inflammation and dietary inflammatory index (DII) is a new tool for assessment of inflammatory potential of diet. The aim of this study was to evaluate the application of DII on dietary intake of HD patients and examine the associations between DII and malnutrition-inflammation markers.
  
  
  METHODS
  A total of 105 subjects were recruited for this cross-sectional study. Anthropometric measurements, 3-day dietary recall, and pre-dialysis biochemical parameters were recorded for each subject. Subjective global assessment (SGA), which was previously validated for HD patients, and malnutrition inflammation score (MIS) were used for the diagnosis of protein energy wasting. DII was calculated according to average of 3-day dietary recall data.
  
  
  RESULTS
  DII showed significant correlation with reliable malnutrition and inflammation indicators including SGA (r = 0.28, P < 0.01), MIS (r = 0.28, P < 0.01), and serum C-reactive protein (CRP) (r = 0.35, P < 0.001) in HD patients. When the study population was divided into three subgroups according to their DII score, significant increasing trends across the tertiles of DII were observed for SGA score (P = 0.035), serum CRP (P = 0.001), dietary energy (P < 0.001), total fat (P < 0.001), saturated fatty acids (P < 0.001), polyunsaturated fatty acids (P = 0.006), and omega-6 fatty acids (P = 0.01) intakes.
  
  
  CONCLUSIONS
  This study shows that DII is a good tool for assessing the overall inflammatory potential of diet in HD patients.
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100 Sıhhiye, Ankara, Turkey.
authors.forename: Mevlude
authors.initials: M
authors.lastname: Kizil
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100 Sıhhiye, Ankara, Turkey.
authors.forename: M Merve
authors.initials: MM
authors.lastname: Tengilimoglu-Metin
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100 Sıhhiye, Ankara, Turkey.
authors.forename: Damla
authors.initials: D
authors.lastname: Gumus
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100 Sıhhiye, Ankara, Turkey.
authors.forename: Sumeyra
authors.initials: S
authors.lastname: Sevim
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100 Sıhhiye, Ankara, Turkey.
authors.forename: İnci
authors.initials: İ
authors.lastname: Turkoglu
authors.affiliation: RFM Hemodialysis Units, Ankara, Turkey.
authors.forename: Fahri
authors.initials: F
authors.lastname: Mandiroglu
keywords: Kidney failure; dietary fat; dietary management; inflammation; malnutrition