Simplified Creatinine Index as Predictor of Malnutrition in Stage 5 Chronic Kidney Disease Patients on Maintenance Haemodialysis

Abstract

Background

Malnutrition inflammation score (MIS) is an instrument for assessing the nutritional status of stage 5 CKD patients, while simplified creatinine index (SCI) is used to assess muscle mass indirectly.

Purpose

This study aims to analyse the correlation between SCI and MIS, as well as determine the SCI cut-off value as a predictor of malnutrition in stage 5 CKD patients on maintenance HD.

Methods

This research was an analytical observational study with a cross-sectional study approach. The 132 research subjects were stage 5 CKD patients at the HD Unit of RSUP Dr. Hasan Sadikin Bandung. The research used the Rank–Spearman test with SPSS for correlative bivariate analysis. The area under the curve (AUC) on the receiver operating characteristic (ROC) curve was analysed to find the SCI cut-off value as a predictor of malnutrition in stage 5 CKD patients.

Results

Sixty-three subjects (47.7%) were classified as good nutrition and 69 subjects (52.3%) as poor nutrition. The average SCI value in this study was 24.5 mg/kg/day ± SD 3.2 mg/kg/day, with a median MIS value was 6. This study showed a significant negative correlation between SCI and MIS (r = −0.586, p < 0.001). The optimal SCI cut-off from the ROC curve analysis value was ≤ 24.53 mg/kg/day (sensitivity = 76.8%; specificity = 79.4%).

Conclusion

A negative correlation existed between SCI and MIS, with an SCI value ≤ 24.53 indicating poor nutritional status in stage 5 CKD patients on maintenance HD. SCI can be used as a predictor of malnutrition at a lower cost and easier.

Keywords:

• malnutrition
• simplified creatinine index
• chronic kidney disease

Ethics Approval

This study received approval from the Health Research Ethics Committee of Hasan Sadikin General Hospital (Letter number: LB.02.01/X.6.5/291/2023). Ethical approval for this research complies with the provisions of the Declaration of Helsinki.

Acknowledgment

The authors gratefully acknowledge all staff in HD Unit of Dr. Hasan Sadikin Hospital Bandung for providing assistance in managing the patients. We are grateful to statistical analysts Mr. Evan Susandi for their help in data analysis.

Consent for Publication

The authors declare that this manuscript is original, has not been published before, and is not currently being considered for publication. All authors consent to the publication of this manuscript.

Disclosure

The authors declare that there is no conflict of interest regarding the publication of this paper.

Additional information

Funding

The authors received no funding for this work.