The Prevalence of Malnutrition Inflammation Complex Syndrome in maintenance haemodialysis patients at Charlotte Maxeke Johannesburg hospital

Abstract

Background: The malnutrition inflammation complex syndrome in patients on chronic haemodialysis (HD) is an important factor that affects patients’ outcome. The malnutrition inflammation score (MIS) measures the severity of this syndrome. The association between age, sex, race, duration on dialysis, hospitalisation frequency, co-morbidities, aetiologies of end stage renal disease (ESRD) and MIS has not been fully studied in the state dialysis sector. Method: All patients on maintenance HD at Charlotte Maxeke Johannesburg Academic Hospital were studied. MIS as well as the above mentioned variables were obtained. The association between MIS and each of the variables were investigated. Results: A total of 68 patients were enrolled into the study. The study showed a significant p-value when assessing the association between hospitalisation frequency, hypertension and renal failure associated co-morbidities and MIS, 0.002, 0.02 and 0.03 respectively. These variables have shown to occur in increasing frequency in those with low MIS. A number of biases and pathophysiological concepts are discussed, as possible explanations to these associations. Age, sex, race, dialysis time and Kt/V [marker of dialysis clearance, calculated as the coefficient of K (dialyser clearance of urea) and t (dialysis time) divided by V (volume of distribution of urea, approximately equal to patient's total body water)] were not significant in relation to MIS. Conclusion: Despite the number of limitations in the current study, MIS is proven to be a useful tool to assess patients’ risk of complications whilst aiding in improving the overall clinical outcome in dialysis patients. More longitudinal studies with a larger study population are needed to make a well grounded understanding of the associations between these variables and MIS.