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

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dc.contributor.author Amparo, Fernanda C. [UNIFESP]
dc.contributor.author Kamimura, Maria Ayako [UNIFESP]
dc.contributor.author Molnar, Miklos Z.
dc.contributor.author Cuppari, Lilian [UNIFESP]
dc.contributor.author Lindholm, Bengt
dc.contributor.author Amodeo, Celso
dc.contributor.author Carrero, Juan J.
dc.contributor.author Cordeiro, Antonio C.
dc.date.accessioned 2016-01-24T14:40:28Z
dc.date.available 2016-01-24T14:40:28Z
dc.date.issued 2015-05-01
dc.identifier http://dx.doi.org/10.1093/ndt/gfu380
dc.identifier.citation Nephrology Dialysis Transplantation. Oxford: Oxford Univ Press, v. 30, n. 5, p. 821-828, 2015.
dc.identifier.issn 0931-0509
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/39064
dc.description.abstract 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. en
dc.description.sponsorship Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorship Adib Jatene's Foundation
dc.description.sponsorship Swedish Research Council
dc.format.extent 821-828
dc.language.iso eng
dc.publisher Oxford Univ Press
dc.relation.ispartof Nephrology Dialysis Transplantation
dc.rights Acesso restrito
dc.subject acute phase response en
dc.subject outcomes en
dc.subject renal disease en
dc.subject undernutrition en
dc.subject uremia en
dc.title Diagnostic validation and prognostic significance of the Malnutrition-Inflammation Score in nondialyzed chronic kidney disease patients en
dc.type Artigo
dc.rights.license http://www.oxfordjournals.org/access_purchase/self-archiving_policyb.html
dc.contributor.institution Dante Pazzanese Inst Cardiol
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Univ Tennessee
dc.contributor.institution Karolinska Inst
dc.description.affiliation Dante Pazzanese Inst Cardiol, Dept Nutr, São Paulo, Brazil
dc.description.affiliation Universidade Federal de São Paulo, Div Nephrol, Nutr Program, São Paulo, Brazil
dc.description.affiliation Univ Tennessee, Hlth Sci Ctr, Div Nephrol, Dept Med, Memphis, TN USA
dc.description.affiliation Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Renal Med, Stockholm, Sweden
dc.description.affiliation Karolinska Inst, Dept Clin Sci Intervent & Technol, Baxter Novum, Stockholm, Sweden
dc.description.affiliation Karolinska Inst, Ctr Mol Med, Stockholm, Sweden
dc.description.affiliation Dante Pazzanese Inst Cardiol, Dept Hypertens & Nephrol, São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Div Nephrol, Nutr Program, São Paulo, Brazil
dc.description.sponsorshipID FAPESP: 2010/16593-2
dc.identifier.doi 10.1093/ndt/gfu380
dc.description.source Web of Science
dc.identifier.wos WOS:000355315300018



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