Mortality risk assessment using the malnutrition and inflammation scale and hand grip strength in patients with chronic kidney disease undergoing hemodialysis treatment.

A single-center observational study.

Abstract

Introduction: Introduction: Patients with chronic kidney disease on maintenance hemodialysis often struggle with malnutrition and sarcopenia. Different studies have defined the malnutrition and inflammation score (MIS) and the handgrip strength test (HST) as independent risk factors. This study aimed to perform the two tests in a group of patients on a hemodialysis program.

Methods: This is a cross-sectional study carried out in the hemodialysis service of UMAE 71, Coahuila, Mexico. The variables were: demographic, clinical, laboratory, MIS, HST, and mortality. The sample was non-probabilistic.

Results: 101 patients were analyzed, 50.5% men. Mortality was 25.74%, and the most frequent cause of death was acute myocardial infarction, 34.61%, followed by SARS CoV2 pneumonia, 23.07%. The HST between men and women, for the right hand, was 17.71 ± 11.94 vs. 11.5 ± 6.99, P=0.0002, and for the left hand, 14.63 ± 7.06 vs. 10.31 ± 4.98, P=0.0001. The area under the ROC curve for the MIS was 0.562 and 0.567 for handgrip strength for men and women. A sensitivity of 96% and a specificity of 17% for the HST, and for the MIS, a sensitivity of 92% and a specificity of 20% were found.

Conclusion: MIS and HST are indicators with low discriminative capacity. The present study found high sensitivity and low specificity for both tests, which does not guarantee their reliable application to assess the risk of short-term mortality (<12 months) in patients older than 18 years with chronic kidney disease on hemodialysis.