Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Practice Point
  • Published:

Malnutrition–Inflammation Score for risk stratification of patients with CKD: is it the promised gold standard?

Nature Clinical Practice Nephrology volume 4, pages 354–355 (2008)Cite this article

Abstract

Traditional cardiovascular disease risk factors including hyperlipidemia and obesity are paradoxically associated with improved survival in individuals with advanced chronic kidney disease. Such paradoxes underscore the important role of malnutrition–inflammation–cachexia syndrome in chronic kidney disease mortality and highlight the urgent need for comprehensive but practical nutritional assessment tools. In this Practice Point commentary, Rambod and colleagues discuss a recent paper by Yamada et al. that used the Malnutrition–Inflammation Score (MIS) as the 'reference standard' to validate five simplified nutritional screening tools in 422 Japanese patients on hemodialysis. The study found the Geriatric Nutritional Risk Index to be the most accurate of the simplified tools for identifying those patients on dialysis who are at nutritional risk. The commentary authors discuss Yamada et al.'s study and conclude that although the MIS has been widely used in patients undergoing maintenance dialysis, its wide utility does not automatically make it the ultimate reference standard for assessing other nutritional scoring tools.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Wanner C et al. (2005) Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med 353: 238–248

    Article  CAS  PubMed  Google Scholar 

  2. Kalantar-Zadeh K et al. (2007) Racial and survival paradoxes in chronic kidney disease. Nat Clin Pract Nephrol 3: 493–506

    Article  PubMed  Google Scholar 

  3. Kalantar-Zadeh K et al. (2001) A malnutrition–inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. Am J Kidney Dis 38: 1251–1263

    Article  CAS  PubMed  Google Scholar 

  4. Elsurer R et al. (2007) Malnutrition inflammation score is associated with coronary artery disease in hepatitis C virus-infected hemodialysis patients. Eur J Clin Nutr [10.1038/sj.ejcn.1602867]

  5. Chan JY et al. (2007) Comprehensive malnutrition inflammation score as a marker of nutritional status in Chinese peritoneal dialysis patients. Nephrology (Carlton) 12: 130–134

    Article  Google Scholar 

  6. Yamada K et al. (2008) Simplified nutritional screening tools for patients on maintenance hemodialysis. Am J Clin Nutr 87: 106–113

    Article  CAS  PubMed  Google Scholar 

  7. Kalantar-Zadeh K et al. (2007) Risk factor paradox in wasting diseases. Curr Opin Clin Nutr Metab Care 10: 433–442

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institute of Health (R01 DK078106 and R21078012) and a philanthropic grant from Mr Harold Simmons.

Author information

Authors and Affiliations

  1. M Rambod is Postdoctoral Research Fellow in the Harold Simmons Center for Kidney Disease Research and Epidemiology at the Los Angeles Biomedical Research Institute at Harbor–UCLA Medical Center, Salem, VA, USA,

    Mehdi Rambod

  2. CP Kovesdy is Assistant Professor of Medicine at the University of Virginia and Chief of Nephrology at Salem Veterans Affairs Medical Center, Salem, VA, USA,

    Csaba P Kovesdy

  3. K Kalantar-Zadeh is Associate Professor of Medicine, Pediatrics and Epidemiology at the UCLA David Geffen School of Medicine and Director of the Off-Campus Dialysis Expansion Program at Harbor–UCLA Medical Center, Torrance, CA, USA.,

    Kamyar Kalantar-Zadeh

Authors
  1. Mehdi Rambod
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Csaba P Kovesdy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kamyar Kalantar-Zadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kamyar Kalantar-Zadeh.

Ethics declarations

Competing interests

K Kalantar-Zadeh has declared associations with the following companies: Novo Nordisk (manufacturer of a growth hormone; honoraria), and Abbott Nutrition (manufacturer of Nepro and Oxepa; grant/research support). The other authors declared no competing interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rambod, M., Kovesdy, C. & Kalantar-Zadeh, K. Malnutrition–Inflammation Score for risk stratification of patients with CKD: is it the promised gold standard?. Nat Rev Nephrol 4, 354–355 (2008). https://doi.org/10.1038/ncpneph0834

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpneph0834

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing