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Assessment of Malnutrition Prevalence and Malnutrition Inflammation Score in Predialisis Chronic Kidney Disease

Year 2025, Volume: 12 Issue: 1, 110 - 129

Sümeyye Kemaneci , Alev Keser

Abstract

Objectives: It is recommended to use combined nutritional indices to evaluate the nutritional status of individuals with chronic kidney disease (CKD). The aim of this study was to determine the Malnutrition Inflammation Score (MIS) level in individuals with CKD who were not receiving dialysis treatment and to evaluate the anthropometric measurements, biochemical parameters, and nutritional status of individuals according to CKD stage and MIS.
Materials and Methods: The study was conducted with 118 predialysis individuals with CKD. Nutritional status of individuals was determined by Subjective Global Assessment (SGA) and MIS. It was accepted that the severity of malnutrition increased as the MIS score increased.
Results: It was defined that 20.3% of individuals had moderate/severe malnutrition according to SGA, and as the CKD stage increased, the MIS increased significantly. It had been determined that individuals' lean body mass, blood glucose, albumin, urea, creatinine, ferritin, calcium, and phosphorus; intake of protein, total fat, monounsaturated fatty acid, omega-3 fatty acid, cholesterol, riboflavin, vitamin B12, calcium, phosphorus, and zinc vary depending on their CKD stage (p<0,05). Individuals' MIS value had a significant correlation with upper middle arm circumference, body fat percentage (BFP), calcium, and urea levels. The BFP (4.2%) and serum calcium (7.3%) levels mostly explain the MIS.
Conclusion: MIS is associated with CKD stage, anthropometric measurements, and biochemical parameters. Therefore, using MIS at regular intervals will be effective in reducing the prevalence of malnutrition and the cost of disease in CKD and increasing the quality of life of patients.

Keywords

anthropometric measurements nutrition biochemical parameters chronic kidney disease inflammation score

References

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Prediyaliz Kronik Böbrek Hastalığında Malnütrisyon Prevalansının ve Malnütrisyon İnflamasyon Skorunun Değerlendirilmesi

Year 2025, Volume: 12 Issue: 1, 110 - 129

Sümeyye Kemaneci , Alev Keser

Abstract

Amaç: Kronik böbrek hastalığı (KBH) olan bireylerin beslenme durumlarını değerlendirmede bileşik beslenme indekslerinin kullanılması önerilmektedir. Bu çalışmanın amacı, diyaliz tedavisi almayan KBH’li bireylerde Malnütrisyon İnflamasyon Skoru (MİS) düzeyinin belirlenerek KBH evresine ve MİS’e göre bireylerin antropometrik ölçümlerinin, biyokimyasal parametrelerinin ve beslenme durumlarının değerlendirilmesidir.
Gereç ve Yöntem: Çalışma, prediyaliz 118 KBH’li birey ile yürütülmüştür. Bireylerin beslenme durumları Subjektif Global Değerlendirme (SGD) ve MİS ile belirlenmiştir. MİS’in artmasıyla malnütrisyon şiddetinin arttığı kabul edilmiştir.
Bulgular: Bireylerin SGD’ye göre %20,3’ünde orta/ciddi düzeyde malnütrisyon görüldüğü ve KBH evresi arttıkça MİS’in anlamlı düzeyde arttığı belirlenmiştir. Bireylerin KBH evrelerine göre yağsız vücut kütlesi, kan glukozu, albümin, üre, kreatinin, ferritin, kalsiyum, fosfor düzeylerinin; protein, toplam yağ, tekli-doymamış yağ asidi, omega-3 yağ asidi, kolesterol, riboflavin, B12 vitamini, kalsiyum, fosfor ve çinko alım miktarlarının farklılık gösterdiği saptanmıştır (p<0,05). Bireylerin MİS değeri; üst orta kol çevresi, vücut yağ yüzdesi (VYY), kalsiyum ve üre düzeyleri ile anlamlı ilişkiye sahiptir (p<0,05) ve MİS’i en fazla VYY (%4,2) ve serum kalsiyum (%7,3) düzeyleri açıklamaktadır.
Sonuç: MİS; KBH evresi, antropometrik ölçümler ve biyokimyasal parametreler ile ilişkilidir. Bu nedenle belirli aralıklarla MİS’in kullanılması, KBH’de malnütrisyon prevalansının ve hastalık maliyetinin azalmasında, hastaların yaşam kalitesinin artmasında etkili olacaktır.

Keywords

antropometrik ölçümler beslenme biyokimyasal parametreler kronik böbrek hastalığı malnütrisyon inflamasyon skoru

Ethical Statement

Araştırmanın etik kurul onayı 18.06.2019 tarihinde Ankara Üniversitesi klinik araştırmalar etik kurulun 38970 karar numarasıyla alınmıştır.

References

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  • Aggarwal, H. K., Jain, D., Chauda, R., Bhatia, S., & Sehgal, R. (2018). Assessment of Malnutrition Inflammation Score in Different Stages of Chronic Kidney Disease. Prilozi (Makedonska Akademija na Naukite Umetnostite Oddelenie za Medicinski Nauki)., 39(2-3), 51-61. doi: 10.2478/prilozi-2018-0042. https://doi.org/10.2478/prilozi-2018-0042
  • Amparo, F. C., Cordeiro, A. C., Carrero, J. J., Cuppari, L., Lindholm, B., Amodeo, C., & Kamimura, M. A. (2013). Malnutrition-inflammation score is associated with handgrip strength in nondialysis-dependent chronic kidney disease patients. Journal of Renal Nutrition, 23(4), 283-7. https://doi.org/10.1053/j.jrn.2012.08.004
  • Amparo, F. C., Kamimura, M. A., Molnar, M. Z., Cuppari, L., Lindholm, B., Amodeo, C.,Carrero, J. J., & Cordeiro, A. C. (2015). Diagnostic validation and prognostic significance of the Malnutrition-Inflammation Score in nondialyzed chronic kidney disease patients. Nephrology Dialysis Transplantation, 30(5), 821-8. https://doi.org/10.1093/ndt/gfu380
  • Anupama, S. H., Abraham, G., Alex, M., Vijayan, M., Subramanian, K. K., Fernando, E., Nagarajan, V., & Nageshwara Rao, P. K. (2020). A multicenter study of malnutrition status in chronic kidney disease stages I-V-D from different socioeconomic groups. Saudi Journal of Kidney Diseases and Transpantation, 31(3), 614-623. https://doi.org/10.4103/1319-2442.289448
  • Caldiroli, L., Armelloni, S., Eskander, A., Messa, P., Rizzo, V., Margiotta, E., Cesari, M., & Vettoretti, S. (2021). Association between the uremic toxins indoxyl-sulfate and p-cresyl-sulfate with sarcopenia and malnutrition in elderly patients with advanced chronic kidney disease. Experimental Gerontology, 147, 111266. https://doi.org/10.1016/j.exger.2021.111266
  • Chazot, C. (2009). Why are chronic kidney disease patients anorexic and what can be done about it?. Seminars in Nephrology, 29(1), 15-23. https://doi.org/10.1016/j.semnephrol.2008.10.003
  • Chen, M. E., Hwang, S. J., Chen, H. C., Hung, C. C., Hung, H. C., Liu, S. C., Wu, T. J., & Huang, M. C. (2017). Correlations of dietary energy and protein intakes with renal function impairment in chronic kidney disease patients with or without diabetes. The Kaohsiung Journal of Medical Sciences, 33(5), 252-259. https://doi.org/10.1016/j.kjms.2017.03.002
  • Duenhas, M. R., Draibe, S. A., Avesani, C. M., Sesso, R., & Cuppari, L. (2003). Influence of renal function on spontaneous dietary intake and on nutritional status of chronic renal insufficiency patients. European Journal of Clinical Nutrition, 57(11), 1473-8. https://doi.org/10.1038/sj.ejcn.1601713
  • Elia, M., Normand, C., Laviano, A., & Norman, K. (2016). A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings. Clinical Nutrition, 35(1), 125-137. https://doi.org/10.1016/j.clnu.2015.07.012
  • Espinosa-Cuevas, M. Á. (2001). Ìndices compuestos para la obtenciòn del diagnòstico nutricio en pacientes con insuficiencia renal. Nutriciòn Clinica, 4: 230-237.
  • Fernando, B. N. T. W., Sudeshika, T. S. H., Hettiarachchi, T. W., Badurdeen, Z., Abeysekara, T. D. J., Abeysundara, H. T. K., Jayasinghe, S., Ranasighe, S., & Nanayakkara, N. (2020). Evaluation of biochemical profile of Chronic Kidney Disease of uncertain etiology in Sri Lanka. PLoS One, 15(5), e0232522. https://doi.org/10.1371/journal.pone.0232522
  • Fouque, D., Kalantar-Zadeh, K., Kopple, J., Cano, N., Chauveau, P., Cuppari, L., Franch, H., Guarnieri, G., Ikızler, T. A., Kaysen, G., Lindholm, B., Massy, Z., Mitch, W., Pineda, E., Stenvinkel, P., Treviño-Becerra, A., & Wanner, C. (2008). A proposed nomenclature and diagnostic criteria for protein–energy wasting in acute and chronic kidney disease. Kidney International, 73(4), 391-398. https://doi.org/10.1038/sj.ki.5002585
  • Gonzalez-Ortiz, A. J., Arce-Santander, C. V., Vega-Vega, O., Correa-Rotter, R., & Espinosa-Cuevas, M. A. (2015). Assessment of the reliability and consistency of the “Malnutrition Inflammation Score” (MIS) in Mexican adults with chronic kidney disease for diagnosis of protein-energy wasting syndrome (PEW). Nutriciòn Hospitalaria, 31(3), 1352-1358. https://doi.org/10.3305/nh.2015.31.3.8173
  • Gupta, D., & Lammersfeld, C. A. (2005). Prognostic Significance of Subjective Global Assessment (SGA) in advanced colorectal cancer. European Journal of Clinical Nutrition, 59(1), 35–40. https://doi.org/10.1038/sj.ejcn.1602029
  • Hyun, Y. Y., Lee, B. L., Rhee, E. J., Park, C. Y., Chang, Y, & Ryu, S. (2016). Chronic kidney disease and high eGFR according to body composition phenotype in adults with normal BMI. Nutrition, Metabolism and Cardiovascular Diseases, 26(12), 1088-1095. https://doi.org/10.1016/j.numecd.2016.09.003
  • Hyun, Y. Y., Lee, K. B., Han, S. H., Kim, Y. H., Kim, Y. S., Lee, S. W., Oh, Y. K., Chae, D. W., & Ahn, C. (2017a). Nutritional Status in Adults with Predialysis Chronic Kidney Disease: KNOW-CKD Study. Journal of Korean Medical Science, 32(2), 257-263. https://doi.org/10.3346/jkms.2017.32.2.257
  • Hyun, Y. Y., Lee, K. B., Oh, K. H., Ahn, C., Park, S. K., Chae, D. W., Yoo, T. H., Cho, K. H., Kim, Y. S., Hwang, Y. H., & Representing Know-Ckd Study Group (2017b). Serum adiponectin and protein-energy wasting in predialysis chronic kidney disease. Nutrition, 33, 254-260. https://doi.org/10.1016/j.nut.2016.06.014
  • Jagadeswaran, D., Indhumathi, E., Hemamalini, A. J., Sivakumar, V., Soundararajan, P., & Jayakumar, M. (2019). Inflammation and nutritional status assessment by malnutrition inflammation score and its outcome in pre-dialysis chronic kidney disease patients. Clinical Nutrition, 38, 341-347. https://doi.org/10.1016/j.clnu.2018.01.001
  • Kalantar-Zadeh, K., Kopple, J. A., Block, G., & Humphreys, M. H. (2001). A malnutrition-inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. American Journal of Kidney Diseases, 38(6), 1251–1263. https://doi.org/10.1053/ajkd.2001.29222
  • Kalantar-Zadeh, K., Kopple, J. D., Humphreys, M. H., & Block, G. (2004). Comparing outcome predictability of markers of malnutrition-inflammation complex syndrome in haemodialysis patients. Nephrology Dialysis Transplantation, 19, 1507–19. https://doi.org/10.1093/ndt/gfh143
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There are 43 citations in total.

Details

Primary Language Turkish
Subjects Clinical Nutrition
Journal Section Articles
Authors

Sümeyye Kemaneci 0000-0001-6974-8461

Alev Keser 0000-0003-2620-6747

Early Pub Date April 22, 2025
Publication Date
Submission Date July 19, 2024
Acceptance Date September 30, 2024
Published in Issue Year 2025 Volume: 12 Issue: 1

Cite

APA Kemaneci, S., & Keser, A. (2025). Prediyaliz Kronik Böbrek Hastalığında Malnütrisyon Prevalansının ve Malnütrisyon İnflamasyon Skorunun Değerlendirilmesi. Hacettepe University Faculty of Health Sciences Journal, 12(1), 110-129. https://doi.org/10.21020/husbfd.1519114
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