Malnutrition-Inflammation Score and Endothelial Dysfunction in Hemodialysis Patients

Demir, Murat; Kucuk, Adem; Sezer, Mehmet Tugrul; Altuntas, Atila; Kaya, Selcuk

doi:10.1053/j.jrn.2010.03.002

« Previous Next »Journal of Renal Nutrition
Volume 20, Issue 6 , Pages 377-383, November 2010

Malnutrition-Inflammation Score and Endothelial Dysfunction in Hemodialysis Patients

Murat Demir, MD
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Suleyman Demirel University, Isparta, Turkey
- Address reprint requests to Murat Demir, MD, Division of Nephrology, Department of Internal Medicine, School of Medicine, Suleyman Demirel Universitesi, Tip Fakultesi, Ic Hastaliklari A.D. Dogu Kampusu, 32260 Isparta, Turkey.
Adem Kucuk, MD
- Department of Internal Medicine, School of Medicine, Suleyman Demirel University, Isparta, Turkey
Mehmet Tugrul Sezer, MD
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Suleyman Demirel University, Isparta, Turkey
Atila Altuntas, MD
- Department of Internal Medicine, School of Medicine, Suleyman Demirel University, Isparta, Turkey
Selcuk Kaya, MD
- Department of Microbiology, School of Medicine, Suleyman Demirel University, Isparta, Turkey

published online 22 July 2010.

Objective

The aim of this study was to find out the relationship between Malnutrition-Inflammation score (MIS) and the endothelial function parameters, including measurements of flow-mediated vasodilatation (FMD) in the brachial artery and serum vascular cell adhesion molecule-1 (VCAM-1). Furthermore, predictors of FMD were also assessed.

Materials and Methods

A total of 70 anuric hemodialysis patients were enrolled in this cross-sectional study. Measurements of FMD, serum VCAM-1, oxidized low density lipoprotein cholesterol (oxLDL) were done before the mid-week dialysis session from all participants at the time of MIS calculation. Patients were divided into 3 groups according to MIS (the MIS was ≤4 in group I, 4< and ≤7 in group II, and >7 in group III) and compared for above parameters.

Results

Patients with higher MIS had higher serum high sensitive C-reactive protein, oxLDL and VCAM-1 levels whereas these patients had lower serum albumin, hemoglobin levels, and FMD rates. MIS was positively correlated with high sensitive C-reactive protein, oxLDL and VCAM-1 levels. However, there was a negative correlation between MIS and FMD. MIS and oxLDL were found as an independent significant predictors of FMD (P = .014 and P = .018, respectively) in a multivariate analysis.

Conclusions

MIS is a useful tool in prediction of the severity of endothelial dysfunction. Furthermore, decrease in MIS by the modifiable parameters and also treatment of oxLDL could be expected to improve endothelial dysfunction in hemodialysis patients.