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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Diagnostic validation and prognostic significance of the Malnutrition-Inflammation Score in nondialyzed chronic kidney disease patients

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Amparo, Fernanda C. [1, 2] ; Kamimura, Maria A. [2] ; Molnar, Miklos Z. [3] ; Cuppari, Lilian [2] ; Lindholm, Bengt [4, 5] ; Amodeo, Celso ; Carrero, Juan J. [4, 5, 6] ; Cordeiro, Antonio C. [7]
Total Authors: 8
[1] Dante Pazzanese Inst Cardiol, Dept Nutr, Sao Paulo - Brazil
[2] Univ Fed Sao Paulo, Div Nephrol, Nutr Program, Sao Paulo - Brazil
[3] Univ Tennessee, Hlth Sci Ctr, Div Nephrol, Dept Med, Memphis, TN - USA
[4] Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Renal Med, Stockholm - Sweden
[5] Karolinska Inst, Dept Clin Sci Intervent & Technol, Baxter Novum, Stockholm - Sweden
[6] Karolinska Inst, Ctr Mol Med, Stockholm - Sweden
[7] Dante Pazzanese Inst Cardiol, Dept Hypertens & Nephrol, Sao Paulo - Brazil
Total Affiliations: 7
Document type: Journal article
Source: Nephrology Dialysis Transplantation; v. 30, n. 5, p. 821-828, MAY 2015.
Web of Science Citations: 19

Malnutrition and inflammation are highly prevalent and intimately linked conditions in chronic kidney disease (CKD) patients that lead to a state of protein-energy wasting (PEW), the severity of which can be assessed by the Malnutrition-Inflammation Score (MIS). Here, we applied MIS and validated, for the first time, its ability to grade PEW and predict mortality in nondialyzed CKD patients. We cross-sectionally evaluated 300 CKD stages 3-5 patients {[}median age 61 (53-68) years; estimated glomerular filtration rate 18 (12-27) mL/min/1.73 m(2); 63% men] referred for the first time to our center. Patients were followed during a median 30 (18-37) months for all-cause mortality. A worsening in MIS scale was associated with inflammatory biomarkers increase (i.e. alpha-1 acid glycoprotein, fibrinogen, ferritin and C-reactive protein) as well as a progressive deterioration in various MIS-independent indicators of nutritional status based on anthropometrics, dynamometry, urea kinetics and bioelectric impedance analysis. A structural equation model with two latent variables (assessing simultaneously malnutrition and inflammation factors) demonstrated good fit to the observed data. During a follow-up, 71 deaths were recorded; patients with higher MIS were at increased mortality risk in both crude and adjusted Cox models. MIS appears to be a useful tool to assess PEW in nondialyzed CKD patients. In addition, MIS identified patients at increased mortality risk. (AU)

FAPESP's process: 10/16593-2 - Association between traditional, novel and uremic related risk factors and morbidity/mortality (all-cause and cardiovascular) in chronic kidney disease patients
Grantee:Antonio Carlos Cordeiro Silva Júnior
Support type: Regular Research Grants