Worsening of malnutrition-inflammation score is associated with high ratio of extracellular to total body water in hemodialysis patients

The Malnutrition-Inflammation Score (MIS) has been reported to be associated with mortality in hemodialysis (HD) patients. Bioelectrical impedance analysis is useful for assessing the body fluid components. The purpose of this study is to evaluate the association between change in MIS and fluid components in HD patients. A total of 76 patients who were receiving a 5-hour HD, 3 times weekly, were enrolled in this study. MIS was performed every 6 months. Using IN BODY 720, body fluid components were estimated once a year, including intracellular water (ICW), extracellular water (ECW), total body water (TBW), total body fat, body fat percentage and ECW/TBW ratio. In univariate analysis, worsening of MIS was correlated positively with age and ECW/TBW ratio. In multivariate analysis, worsening of MIS was significantly associated with higher ECW/TBW ratio. Higher ECW/TBW ratio remained significantly correlated with worsening of MIS in non-obese HD patients, but not in obese patients. In conclusion, non-obese HD patients who has higher ECW/TBW ratio should be considered to be a risk group for malnutrition