Abstract: PUB254
Assessment of Nutritional Status by Malnutrition-Inflammation Score and Its Associated Factors in Patients with Nondialysis-Dependent CKD
Session Information
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Dias, Akhil Fravis, MS Ramaiah Medical College, Bengaluru, KA, India
- Pulkurthi, Sneha Reddy, MS Ramaiah Medical College, Bengaluru, KA, India
- Shekhar Reddy, Raj, MS Ramaiah Medical College, Bengaluru, KA, India
- K, Navikala, MS Ramaiah Medical College, Bengaluru, KA, India
Background
Chronic Kidney Disease (CKD) affects 9–11% of the population and is frequently complicated by Protein-Energy Wasting (PEW), which increases morbidity and mortality. The Malnutrition-Inflammation Score (MIS) is a critical prognostic tool that integrates medical history, physical examination, and laboratory parameters (serum albumin and TIBC) to assess nutritional status.Uremic toxins and the ubiquitin-proteasome system likely contribute to PEW. This study aims to evaluate MIS and its associated factors in pre-dialysis CKD patients to identify targets for early intervention.
Methods
This cross-sectional study at Ramaiah Hospitals, Bangalore (June–August 2025), enrolled adult pre-dialysis CKD patients. We excluded patients with pregnancy, active chronic infections, primary liver disease, or chronic GI disorders. Nutritional status was assessed using the 10-component MIS (5 history-based, 2 physical exam, and 3 laboratory/biometric components). status). As this study focussed on pre-dialysis, the dialysis vintage was excluded from the final score.
Results
A total of 65 pre-dialysis CKD patients (mean age 56.4 years) were evaluated and categorized into three MIS tertiles: Tertile 1 (MIS 0, n=5), Tertile 2 (MIS 1–5, n=40), and Tertile 3 (MIS>5, n=20). Kruskal-Wallis analysis showed significant differences across tertiles for renal and nutritional markers. Higher MIS scores were significantly associated with lower eGFR (p<0.001), lower serum albumin (p<0.001), and lower TIBC (p<0.001). Spearman correlation confirmed that MIS had strong significant negative correlations with eGFR (rho=-0.470, p<0.001), serum albumin (rho=-0.470, p<0.001), and TIBC (rho=-0.509, p<0.001). A significant positive correlation was observed between MIS and serum creatinine (rho=0.354, p=0.004). Neither diabetes nor hypertension were significantly associated with MIS groups. Lower eGFR and serum albumin levels demonstrated significant associations with increasing MIS scores, suggesting worsening renal function and poor nutritional status
Conclusion
Worsening malnutrition-inflammation status is significantly associated with advanced kidney dysfunction in pre-dialysis CKD. Early nutritional screening using the MIS is vital, as addressing the malnutrition-inflammation nexus may be as essential as managing renal health to improve patient outcomes and potentially slow GFR decline.
Acknowledgment
Generative AI (ChatGPT) was utilized for grammar correction and language polishing during the preparation of this abstract