Correlation between malnutrition-inflammation complex syndrome and prognosis of patients undergoing maintenance hemodialysis

Objective: To explore the correlation between malnutrition-inflammation complex syndrome (MICS) and the prognosis of patients who undergo maintenance hemodialysis (MHD) by retrospective analysis of relevant indexes of malnutrition and inflammation. Methods: A total of 527 patients who underwent MHD for more than 3 months at the Hemodialysis Center of Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 1, 2007 to December 31, 2014 were enrolled and divided into MICS group and non-MICS group. Logistic regression analysis was adopted to analyze risk factors of the incidence of MICS of patients who underwent MHD. The survival rate of patients was analyzed by Kaplan-Meier method. Risk factors of all-cause death and death of cardiovascular diseases of patients with MICS were analyzed by the Cox proportional hazards models. Results: Among 527 patients, there were 441 patients (83.63%) with MICS. Patients of MICS group were older with higher body mass index, longer time of dialysis, and lower level of hemoglobin. Multivariate logistic regression analysis showed that older age, longer time of dialysis, and hemoglobin level less than 100 g/L were independent risk factors of the incidence of MICS of patients who underwent MHD. Kaplan-Meier analysis indicated that all-cause mortality (Log-Rank test, P=0.040) and cardiovascular disease (CVD) mortality (Log-Rank test, P=0.038) of patients with MICS were significantly higher than those of patients without MICS. Cox regression analysis showed that older age, longer time of dialysis, lower levels of hemoglobin and total cholesterol, and higher level of low density lipoprotein were independent risk factors of predicting all-cause death and death of cardiovascular diseases of patients with MICS. Conclusion: The incidence of MICS of patients who undergo MHD is high. The prognosis of patients with MICS is poorer than that of patients without MICS. Anemia is closely correlated with the incidence and prognosis of MICS.