Impact of malnutrition and inflammation status on hospitalization and mortality in maintenance hemodialysis patients
10.3760/cma.j.issn.1001-7097.2012.05.007
- VernacularTitle:维持性血液透析患者营养不良-炎性反应状态与其住院及死亡风险的临床研究
- Author:
Wenlong WANG
;
Maosen LIU
;
Huiling WANG
;
Yunsheng LI
;
Yongjun CHENG
;
Yingjie KE
;
Huazhi LIN
;
Guanghua WU
- Publication Type:Journal Article
- Keywords:
Renal dialysis;
Malnutrition;
Inflammation;
Malnutrition-inflammation score
- From:
Chinese Journal of Nephrology
2012;28(5):383-387
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact and the associated parameters of malnutrition and inflammation status on hospitalization and mortality of maintenance hemodialysis (MHD) patients. Method A total of 118 MHD patients were included in the study with 1 year's follow-up.The malnutrition and inflammation parameters were compared between the hospitalized patients and out-patients.Cox's proportional hazard regression model was used to explore the malnutrition and inflammation parameters which could forecast the risk of hospitalization and mortality. Result The hospitalization rate of MHD patients with mild,moderate and severe malnuttition was 32.93％,56.67％ and 83.33％ respectively,and the mortality was 3.66％,6.67％ and 80.00％ respectively.The hospitalization rate of MHD patients with or without microinflammation status was 56.45％ and 46.43％,and the mortality was 14.29％ and 1.61％.Inpatients had a higher malnutrition-inflammation score(MIS,8.36 vs 5.86,P＜0.05) and subjective global assessment of nutrition (MQSGA,14.49 vs 12.88,P＜0.05),a lower creatinine level (886.83 μmol/L vs 991.76 μmol/L,P＜0.05 ) and a lower albumin level (38.57 g/L vs 40.27 g/L,P＜0.05) than out-patients.Inpatients also had a higher level of TNF-α (65.41 μg/L vs 59.76 μg/L,P＜0.05) than out-patients.Cox proportional hazard model analysis showed that MIS and TNF-α were associated with patient's first hospitalization risk. Conclusions For the MHD patients,the more severe the malnutrition and micro-inflammation status is,the worse the clinical outcome is.The higher levels of MIS and TNF-α result in greater risk of hospitalization.
