Association of the malnutrition-inflammation score with anthropometry and body composition measurements in patients with chronic kidney disease

Wen-Ling Wang, Shuang Liang, Fang-Lei Zhu, Jie-Qiong Liu, Xiang-Mei Chen, Guang-Yan Cai


Background: The malnutrition-inflammation score (MIS) is a nutritional scoring system that has been validated in chronic kidney disease (CKD) stages III-V, especially in dialysis patients. We aimed to test whether the MIS changed in the early stages of CKD and whether it was associated with anthropometry and body composition measurements (BCMs) in patients with CKD.
Methods: This was a cross-sectional study conducted in the Nephrology Department. A total of 144 patients with CKD were included in the study between May 2017 and December 2017. The MIS was calculated without computing the dialysis vintage in the scoring. Body composition was measured using a portable whole-body bioimpedance spectroscopy device. Anthropometric, laboratory, and other body composition parameters were recorded.
Results: The MIS was increased in patients with CKD. It was negatively correlated with body mass index (BMI), mid-arm muscle circumference (MAMC), handgrip strength, lean tissue index (LTI), fat tissue index (FTI), phase angle (PA), and hemoglobin and albumin concentrations, and it was positively correlated with sex, overhydration, urinary protein excretion and IL-6. A high MIS was significantly correlated with a low LTI (r=−0.274; P=0.001), low FTI (r=−0.179; P=0.032), overhydration (r=0.457; P<0.001) and low PA (r=−0.475; P<0.001). A rather strong correlation was observed between the PA and the MIS. In the multivariate regressions, after adjusting for age, sex, presence of diabetes, handgrip strength, BMI, overhydration, glomerular filtration rate, albumin and IL-6 concentrations, these relationships did not diminish.
Conclusions: The MIS was strongly linked with indicators of nutrition. As a simple and practical tool for assessing nutritional status, the MIS should be calculated in the early stages of CKD.