Peritoneal dialysis-a sp 436 mis ( malnutrition-inflammation score ) is effective and crucialtool for prognostic prediction of peritoneal dialysis patient

Introduction and Aims:Malnutrition occurs in peritoneal dialysis (PD) patients commonly and may correlate with increased mortality. Several factors, such as protein loss into the peritoneal cavity, chronic inflammation, accumulation of uremic toxins, etc. could influence PD patients' nutritional status. Nutritional assessment of PD patients is a very important process to evaluate their nutritional condition. MIS is a useful tool to assess patients' nutritional status comprehensively. In this study, we validated the efficacy of MIS as a prognostic factor of PD patients. Methods: 40 patients (male 11, female 29) were enrolled into the study. A mean age of the onset of PD was 78.5 ± 7.4 years. All patients had their nutritional status assessed with MIS and were classified into three subgroups corresponding to each MIS score, normal nutritional group (MIS 0-7), mildly impaired group (MIS 8-12), severely impaired group (MIS over 13) respectively. We analyzed patients' survival rates and compared it among three groups using the Kaplan-Meier analysis. Results: Three year survival rates of the normal group, the mildly impaired group and severely impaired group were 72.9%, 71.0% and 35.2% respectively. And we found a significant difference in the mortality between the severely impaired group and the other two groups with a Log-Rank test (P=0.0312). Conclusions: The results of this study indicated that the MIS is one of the prognostic factors for PD patients. MIS is a comprehensive and quantitative nutritional assessment and consists of several components (medical history, physical examination, body mass index and laboratory parameters). According to the scores of each component, we can design therapeutic intervention for patients with malnutrition. MIS is powerful predictor for PD patients.