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Background Malnutrition is important cause of morbidity and mortality in dialysis patients. Early diagnosis of malnutrition in dialysis patients is extremly important for success of nutritional therapy. Malnutritioninflammation score is useful, simple, but time consuming questionary for diagnosis of malnutrition, sarcopenia and cahexia. The comparison between bioimpedance parameter and M.I.S* in dialysis patients Marija Madroniè , medical nurse Dialysis Center, Clinical Department of Nephrology, University Medical Center Ljubljana, Zaloka street 7, Slovenia Figure. MIS. *Major comorbid conditions include congestive heart failure class III or IV, full blown AIDS, severe coronary artery disease, moderate to severe chronic obstructive pulmonary disease, major neurologic sequelae, and metastatic malignancies or s/p recent chemotherapy. Suggested equivalent increments for serum transferrin are 200 (0), 170 to 200 (1), 140 to 170 (2), and 140 mg/dL. Methods Malnutritioninflammation score and bioimpedance body mass indices: phase angle (Phi) as prognostic indicator, lean tissue index (LTI), fat tissue index (FTI), overhydration status (OH), are compared in one Hemodialysis center Ljubljana study (203 patients, L2015 ). Results of linear correlation between MIS and Phase angle are on the picture. High MIS means bad prognosis for malnutrition and quad vitam but low value of Phi has similar meaninig. Value of Phase angle(Phi) is positive dependent of lean tissue index (LTI), but negative with fat tissue index (FTI), and overhydration status (OH). Our experience evaluation method survey M.I.S Overall evaluation with M.I.S questionnaire to us for a period of 6 months does not give the final results. In addition to the two presented patients, I have a short test for all dialysis patients in this center. MIS form reminds us on a patient who may be malnourished, but it is necessary to look in more detail, individually. Such a patient may then be monthly monitored. It is noticeable that the medical condition may deteriorate within two months, this is not seen when this happened in 6.months, or medical condition to deteriorate a the end of month, then this result smashes all previous measurements. Same values of BMI for dialysis patients is not relevant, the result is seductive (example the patient is hypervolemic ... BMI = high, in fact it is worse nourished ... The result, however inaccurate). M.I.S protocol M.I.S*= protocol malnutrition, inflamation the validation of malnutrition Author: Alison L. Steiber, PhD, RD, LD, Kamyar KalantarZadeh, MD, PhD, MPH, Donna Secker, MS, RD, Maureen McCarthy, MPH, RD, CSR, LAshwini Sehgal, MD, and Linda McCann, RD, LD. L 2004 Cleveland. DIALYSIS UKC LJUBLJANA L. 2015 Number of patients with a certan value of the MIS 110 = the chronic dialysis patients without associated acute illnees. Patients with different age period of dialysis treatment. 1120 = the chronic dialysis patients with signs of poor nutrition are also some patients with associated acute disease, inflammatory responses, including elderly patients living in DSO and dialysis patients who were hospitalised or had surgery or are had pneumonia. 2030 = chronic dialysis patients ( hospital septic, amputees and patients with serious complications ). Value MIS Author: Marija Madroniè, medical nurse, Dialysis UMC Ljubljana, L 2015 Conclusion Negative significant correlation between Phase angle and malnutritioninflammation score is present. Low values of Phi with negative prognosys in dialysis patients are connected with high malnutritioninflammation score, which also results in bad prognosis. Phi is useful, simple and fast in showing malnutrition and bad prognosis in dialysis patients. Malnutrition therapy should therefore be started based on bioimpedance body mass compositions results. BIA has good reliability as compared to other accepted methods of body composition analysis. Phase angle is a good marker of nutrition status in hemodialysis patients and patients with low values of phase angle need more intensive observation, diagnostic and nutritional intervention. Dialysis patients is very complex, so a single questionnaire is often insufficient for the actual assessment of the patient? Nutritional status. M.I.S. questionnaire us otherwise extract dietary risk patients, which can then be monitored on a monthly basis / doctor / dietician / nurse. Using BCM us the most accurate information about the patient's nutritional status, details about the actual state of the entire cell body / anabolism / catabolism. Literature: 1. Alison L. Steiber, PhD, RD, LD, Kamyar KalantarZadeh, MD, PhD, MPH, Donna Secker, MS, RD, Maureen McCarthy, MPH, RD, CSR, LAshwini Sehgal, MD, and Linda McCann, RD, LD. L 2004 Cleveland. 2. Subjective Global Assessment in Chronic Kidney Disease: A ReviewAlison L. Steiber, PhD, RD, LD, *Kamyar KalantarZadeh, MD, PhD, MPH, Donna Secker, MS, RD, Maureen McCarthy, MPH, RD, CSR, LD,§ Ashwini Sehgal, MD,and Linda McCann, RD, LD. L 2004, CASE School of Medicine [email protected], WG38 Cleveland, OH 44106 Alison Steiber is a registered dietitian who completed a B. S. In dietetics at Minnesota State at Mankato, a dietetic internship and M.S. in Human Nutrition at The University of Kansas Medical Center, and a Ph.D. in Nutrition from Michigan State University. Prior to joining the faculty at Case Western Reserve University she was a Manager of Nutrition Services for a dialysis center and a clinical dietitian in a medical center. Dr. Steiber's areas of interest are nutritional assessment, chronic kidney disease and carnitine. 3. Malnutrition inflammationscore Is Corelated with Morbidity and Mortality in Maintenance Hemodialysis Patients. American Journal of Kidney Diseasers, Vol 38, No 6 (December), 2001: pp 1251 1263. 4. Dialysis Paper individual patient to be treated with Hemodialysis,.L 2015 Januar, UKC Ljubljana. 5. Wolfson, M, Strong, CJ, Minturn, D, Gray, DK, Kopple, JD: Nutritional status and lymphocyte function in maintenance hemodialysis patients. Am J Clin Nutr 1984 39:547555, | PubMed | ISI | ChemPort | 6. Cano, N, Fernandez, JP, Lacombe, P, Lankester, M, Pascal, S, Defayolle, M, Labastie, J, Saingra, S: Statistical selection of nutritional parameters in hemodialysed patients. Kidney Int Suppl 1987 22:S178S180, PubMed | ChemPort | Author: Marija Madroniè, medical nurse, Dialysis UMC Ljubljana, L 2015 univerzitetni klinièni center ljubljana
