The Impact of Malnutrition, Inflammation on Cognitive Impairment in Hemodialysis Patients: A Multicenter Study
Introduction: Cognitive impairment is prevalent in patients undergoing hemodialysis (HD), which is related to the nutritional and inflammatory status of this population. Malnutrition-inflammation score (MIS) has been identified as a useful tool to evaluate nutrition and inflammation status. The aim...
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| Veröffentlicht in: | Kidney & blood pressure research 2022-12, Vol.47 (12), p.711-721 |
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| description | Introduction: Cognitive impairment is prevalent in patients undergoing hemodialysis (HD), which is related to the nutritional and inflammatory status of this population. Malnutrition-inflammation score (MIS) has been identified as a useful tool to evaluate nutrition and inflammation status. The aim of this study is to investigate the association between MIS and cognitive impairment in HD patients. Methods: This was a multicenter observational cohort study with 1,591 patients undergoing HD. Nutritional and inflammatory status was evaluated with MIS, anthropometric measurements, and body composition assessments. Cognitive function was evaluated with the Mini Mental State Examination (MMSE). The associations between MIS and cognitive impairment were analyzed by multivariable logistic regression models. Results: Among 1,591 HD patients, the mean MIS was 6.0 ± 2.6. Patients with higher MIS had significantly lower MMSE scores. 311 patients had cognitive impairment. After adjusting clinical confounders, higher MIS was independently associated with increased rate of cognitive impairment both as a categorized variable (OR, 1.358; 95% CI, 1.010–1.825; p = 0.045) and as a continuous variable (OR, 1.113; 95% CI, 1.053–1.178; p < 0.001). Subgroup analysis showed a stronger association between MIS and cognitive impairment in males, the population with age 41–60 years, and 61–80 years, no smoker, living by oneself, HD combined with or without hemoperfusion as dialysis modality. ROC curve analysis of MIS showed 60.1% sensitivity and 52.0% specificity in predicting cognitive impairment (AUC 0.604; 95% CI 0.567–0.640, p < 0.001). Conclusions: MIS was independently associated with cognitive impairment in HD patients. |
| doi_str_mv | 10.1159/000527453 |
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Malnutrition-inflammation score (MIS) has been identified as a useful tool to evaluate nutrition and inflammation status. The aim of this study is to investigate the association between MIS and cognitive impairment in HD patients. Methods: This was a multicenter observational cohort study with 1,591 patients undergoing HD. Nutritional and inflammatory status was evaluated with MIS, anthropometric measurements, and body composition assessments. Cognitive function was evaluated with the Mini Mental State Examination (MMSE). The associations between MIS and cognitive impairment were analyzed by multivariable logistic regression models. Results: Among 1,591 HD patients, the mean MIS was 6.0 ± 2.6. Patients with higher MIS had significantly lower MMSE scores. 311 patients had cognitive impairment. After adjusting clinical confounders, higher MIS was independently associated with increased rate of cognitive impairment both as a categorized variable (OR, 1.358; 95% CI, 1.010–1.825; p = 0.045) and as a continuous variable (OR, 1.113; 95% CI, 1.053–1.178; p < 0.001). Subgroup analysis showed a stronger association between MIS and cognitive impairment in males, the population with age 41–60 years, and 61–80 years, no smoker, living by oneself, HD combined with or without hemoperfusion as dialysis modality. ROC curve analysis of MIS showed 60.1% sensitivity and 52.0% specificity in predicting cognitive impairment (AUC 0.604; 95% CI 0.567–0.640, p < 0.001). Conclusions: MIS was independently associated with cognitive impairment in HD patients.</description><identifier>ISSN: 1420-4096</identifier><identifier>EISSN: 1423-0143</identifier><identifier>DOI: 10.1159/000527453</identifier><identifier>PMID: 36260975</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Adult ; Body composition ; Body mass index ; Care and treatment ; Chronic kidney failure ; Cognition disorders ; Cognitive ability ; Cognitive Dysfunction - etiology ; Comorbidity ; Complications and side effects ; Continuity (mathematics) ; Creatinine ; Diagnosis ; Dialysis ; Disease ; Evaluation ; Hemodialysis ; Hemodialysis patients ; Hemoperfusion ; Humans ; Impairment ; Inflammation ; Inflammation - complications ; Inflammation - diagnosis ; Laboratories ; Lymphocytes ; Male ; Malnutrition ; Malnutrition - complications ; Medical records ; Middle Aged ; Mortality ; Neutrophils ; Nutrition ; Nutritional Status ; Patients ; Prevention ; Quality of life ; Regression analysis ; Regression models ; Renal Dialysis - adverse effects ; Research Article ; Risk factors ; Sociodemographics ; Subgroups ; Uremia ; Variables</subject><ispartof>Kidney & blood pressure research, 2022-12, Vol.47 (12), p.711-721</ispartof><rights>2022 The Author(s). Published by S. Karger AG, Basel</rights><rights>2022 The Author(s). Published by S. Karger AG, Basel.</rights><rights>COPYRIGHT 2022 S. Karger AG</rights><rights>2022 The Author(s). Published by S. Karger AG, Basel . This work is licensed under the Creative Commons Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c530t-cf4b9739b5632132fb908389afa74e1c4e0eb47cbb4a84d00d9887802dd0bd5e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,2102,27635,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36260975$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Yuqi</creatorcontrib><creatorcontrib>Da, Jingjing</creatorcontrib><creatorcontrib>Li, Qian</creatorcontrib><creatorcontrib>Long, Yanjun</creatorcontrib><creatorcontrib>Yuan, Jing</creatorcontrib><creatorcontrib>Zha, Yan</creatorcontrib><title>The Impact of Malnutrition, Inflammation on Cognitive Impairment in Hemodialysis Patients: A Multicenter Study</title><title>Kidney & blood pressure research</title><addtitle>Kidney Blood Press Res</addtitle><description>Introduction: Cognitive impairment is prevalent in patients undergoing hemodialysis (HD), which is related to the nutritional and inflammatory status of this population. Malnutrition-inflammation score (MIS) has been identified as a useful tool to evaluate nutrition and inflammation status. The aim of this study is to investigate the association between MIS and cognitive impairment in HD patients. Methods: This was a multicenter observational cohort study with 1,591 patients undergoing HD. Nutritional and inflammatory status was evaluated with MIS, anthropometric measurements, and body composition assessments. Cognitive function was evaluated with the Mini Mental State Examination (MMSE). The associations between MIS and cognitive impairment were analyzed by multivariable logistic regression models. Results: Among 1,591 HD patients, the mean MIS was 6.0 ± 2.6. Patients with higher MIS had significantly lower MMSE scores. 311 patients had cognitive impairment. After adjusting clinical confounders, higher MIS was independently associated with increased rate of cognitive impairment both as a categorized variable (OR, 1.358; 95% CI, 1.010–1.825; p = 0.045) and as a continuous variable (OR, 1.113; 95% CI, 1.053–1.178; p < 0.001). Subgroup analysis showed a stronger association between MIS and cognitive impairment in males, the population with age 41–60 years, and 61–80 years, no smoker, living by oneself, HD combined with or without hemoperfusion as dialysis modality. ROC curve analysis of MIS showed 60.1% sensitivity and 52.0% specificity in predicting cognitive impairment (AUC 0.604; 95% CI 0.567–0.640, p < 0.001). Conclusions: MIS was independently associated with cognitive impairment in HD patients.</description><subject>Adult</subject><subject>Body composition</subject><subject>Body mass index</subject><subject>Care and treatment</subject><subject>Chronic kidney failure</subject><subject>Cognition disorders</subject><subject>Cognitive ability</subject><subject>Cognitive Dysfunction - etiology</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Continuity (mathematics)</subject><subject>Creatinine</subject><subject>Diagnosis</subject><subject>Dialysis</subject><subject>Disease</subject><subject>Evaluation</subject><subject>Hemodialysis</subject><subject>Hemodialysis patients</subject><subject>Hemoperfusion</subject><subject>Humans</subject><subject>Impairment</subject><subject>Inflammation</subject><subject>Inflammation - complications</subject><subject>Inflammation - diagnosis</subject><subject>Laboratories</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Malnutrition - complications</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neutrophils</subject><subject>Nutrition</subject><subject>Nutritional Status</subject><subject>Patients</subject><subject>Prevention</subject><subject>Quality of life</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Renal Dialysis - adverse effects</subject><subject>Research Article</subject><subject>Risk factors</subject><subject>Sociodemographics</subject><subject>Subgroups</subject><subject>Uremia</subject><subject>Variables</subject><issn>1420-4096</issn><issn>1423-0143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DOA</sourceid><recordid>eNptkk1v1DAQhiMEoqVw4I6QpV5AYsv4I4nd27ICuqIVCMrZcvyxeEnsxU6Q9t_jbcoeELIle2aedzwjT1U9x3CBcS3eAkBNWlbTB9UpZoQuADP68O4OCwaiOame5Lw9YADkcXVCG9KAaOvTKtz-sGg97JQeUXToRvVhGpMffQxv0Dq4Xg2DOlio7FXchBL6PSt8GmwYkQ_oyg7ReNXvs8_oS8GLP1-iJbqZ-tHrYtmEvo2T2T-tHjnVZ_vs_jyrvn94f7u6Wlx__rheLa8XuqYwLrRjnWip6OqGEkyJ6wRwyoVyqmUWa2bBdqzVXccUZwbACM5bDsQY6Ext6Vm1nvOaqLZyl_yg0l5G5eWdI6aNVKmU1lupscMOhFHcNMzyTpC60YLrrnXUtKQpuV7NuXYp_ppsHuXgs7Z9r4KNU5akQIKA4KSg5_-g2zilUDqVhAPjTQv0kPBipjaqvO-Di2NSuixjB69jsM4X_7KluMZMNFAEr2eBTjHnZN2xIwzyMAHyOAGFfXlfwtQN1hzJv19egBcz8FOljU1H4Kg__2_407uvMyF3xtE_wOu-5Q</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Yang, Yuqi</creator><creator>Da, Jingjing</creator><creator>Li, Qian</creator><creator>Long, Yanjun</creator><creator>Yuan, Jing</creator><creator>Zha, Yan</creator><general>S. Karger AG</general><general>Karger Publishers</general><scope>M--</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>3V.</scope><scope>7QL</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>S0X</scope><scope>7X8</scope><scope>DOA</scope></search><sort><creationdate>20221201</creationdate><title>The Impact of Malnutrition, Inflammation on Cognitive Impairment in Hemodialysis Patients: A Multicenter Study</title><author>Yang, Yuqi ; Da, Jingjing ; Li, Qian ; Long, Yanjun ; Yuan, Jing ; Zha, Yan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c530t-cf4b9739b5632132fb908389afa74e1c4e0eb47cbb4a84d00d9887802dd0bd5e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Body composition</topic><topic>Body mass index</topic><topic>Care and treatment</topic><topic>Chronic kidney failure</topic><topic>Cognition disorders</topic><topic>Cognitive ability</topic><topic>Cognitive Dysfunction - etiology</topic><topic>Comorbidity</topic><topic>Complications and side effects</topic><topic>Continuity (mathematics)</topic><topic>Creatinine</topic><topic>Diagnosis</topic><topic>Dialysis</topic><topic>Disease</topic><topic>Evaluation</topic><topic>Hemodialysis</topic><topic>Hemodialysis patients</topic><topic>Hemoperfusion</topic><topic>Humans</topic><topic>Impairment</topic><topic>Inflammation</topic><topic>Inflammation - complications</topic><topic>Inflammation - diagnosis</topic><topic>Laboratories</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Malnutrition</topic><topic>Malnutrition - complications</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neutrophils</topic><topic>Nutrition</topic><topic>Nutritional Status</topic><topic>Patients</topic><topic>Prevention</topic><topic>Quality of life</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Renal Dialysis - adverse effects</topic><topic>Research Article</topic><topic>Risk factors</topic><topic>Sociodemographics</topic><topic>Subgroups</topic><topic>Uremia</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Yuqi</creatorcontrib><creatorcontrib>Da, Jingjing</creatorcontrib><creatorcontrib>Li, Qian</creatorcontrib><creatorcontrib>Long, Yanjun</creatorcontrib><creatorcontrib>Yuan, Jing</creatorcontrib><creatorcontrib>Zha, Yan</creatorcontrib><collection>Karger Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Kidney & blood pressure research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Yuqi</au><au>Da, Jingjing</au><au>Li, Qian</au><au>Long, Yanjun</au><au>Yuan, Jing</au><au>Zha, Yan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Impact of Malnutrition, Inflammation on Cognitive Impairment in Hemodialysis Patients: A Multicenter Study</atitle><jtitle>Kidney & blood pressure research</jtitle><addtitle>Kidney Blood Press Res</addtitle><date>2022-12-01</date><risdate>2022</risdate><volume>47</volume><issue>12</issue><spage>711</spage><epage>721</epage><pages>711-721</pages><issn>1420-4096</issn><eissn>1423-0143</eissn><abstract>Introduction: Cognitive impairment is prevalent in patients undergoing hemodialysis (HD), which is related to the nutritional and inflammatory status of this population. Malnutrition-inflammation score (MIS) has been identified as a useful tool to evaluate nutrition and inflammation status. The aim of this study is to investigate the association between MIS and cognitive impairment in HD patients. Methods: This was a multicenter observational cohort study with 1,591 patients undergoing HD. Nutritional and inflammatory status was evaluated with MIS, anthropometric measurements, and body composition assessments. Cognitive function was evaluated with the Mini Mental State Examination (MMSE). The associations between MIS and cognitive impairment were analyzed by multivariable logistic regression models. Results: Among 1,591 HD patients, the mean MIS was 6.0 ± 2.6. Patients with higher MIS had significantly lower MMSE scores. 311 patients had cognitive impairment. After adjusting clinical confounders, higher MIS was independently associated with increased rate of cognitive impairment both as a categorized variable (OR, 1.358; 95% CI, 1.010–1.825; p = 0.045) and as a continuous variable (OR, 1.113; 95% CI, 1.053–1.178; p < 0.001). Subgroup analysis showed a stronger association between MIS and cognitive impairment in males, the population with age 41–60 years, and 61–80 years, no smoker, living by oneself, HD combined with or without hemoperfusion as dialysis modality. ROC curve analysis of MIS showed 60.1% sensitivity and 52.0% specificity in predicting cognitive impairment (AUC 0.604; 95% CI 0.567–0.640, p < 0.001). Conclusions: MIS was independently associated with cognitive impairment in HD patients.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>36260975</pmid><doi>10.1159/000527453</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Body composition Body mass index Care and treatment Chronic kidney failure Cognition disorders Cognitive ability Cognitive Dysfunction - etiology Comorbidity Complications and side effects Continuity (mathematics) Creatinine Diagnosis Dialysis Disease Evaluation Hemodialysis Hemodialysis patients Hemoperfusion Humans Impairment Inflammation Inflammation - complications Inflammation - diagnosis Laboratories Lymphocytes Male Malnutrition Malnutrition - complications Medical records Middle Aged Mortality Neutrophils Nutrition Nutritional Status Patients Prevention Quality of life Regression analysis Regression models Renal Dialysis - adverse effects Research Article Risk factors Sociodemographics Subgroups Uremia Variables |
| title | The Impact of Malnutrition, Inflammation on Cognitive Impairment in Hemodialysis Patients: A Multicenter Study |
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