Malnutrition-Inflammation Score and Mortality Risk in Peritoneal Dialysis Patients
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Abstract
Background: Malnutrition is highly prevalent in peritoneal dialysis (PD) patients and is linked to increased morbidity and mortality. This study evaluated the association between the malnutrition-inflammation score (MIS) and mortality in PD patients.
Methods: This single-center, retrospective cohort study included 269 PD patients between January 2010 and December 2022. Patients were categorized by MIS levels: mild (Group A), moderate (Group B), and severe (Group C). Groups B and C received targeted nutritional interventions as part of routine care. Patients were followed until death, therapy transition, transplantation, or February 2025.
Results: Group B demonstrated the lowest mortality rate (17.8 per 100 person-years) and a significant survival advantage in Kaplan-Meier survival estimates and multivariable Cox regression after adjustment for confounders. Following interventions, 64% of Group B showed improvement in the MIS category, whereas 65% of Group C remained unchanged. Conversely, 60% of Group A (which received no intervention) experienced a worsening of the MIS category. Older age and diabetes were independent predictors of higher mortality.
Conclusion: Patients with moderate MIS achieved better survival than those with mild or severe MIS, likely driven by targeted interventions. The dynamic shifts across MIS categories underscore the critical need for regular, routine nutritional and inflammatory assessments followed by appropriate interventions.
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