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

Figures & data

Figure 1 Hemodialysis scheme.

Figure 2 MIS questionnaire. *)In the original MIS dialysis treatment age (vintage) contributes to the comorbid condition scoring. 0 if vintage <1 year, 1 if vintage 1–4 years, and at least 2 if vintage >4 years. **) Major co-morbid conditions (MCC) include CHF class III or IV, full blown AIDS, severe coronary artery disease, moderate to severe chronic obstructive pulmonary disease, major neurological sequelae, metastatic malignancy or recent chemotherapy.

Table 1 Baseline Characteristics

Variables	n=132
Age (years), Mean ± Standard Deviation (SD)	47 ± 12
Sex, n (%)
Male	66 (50.0)
Female	66 (50.0)
Duration of Haemodialysis (months), Median (Min-Max)	41 (3–171)
BMI (kg/m^2), Mean ± SD	22.3 ± 3.8
Haemodialysis Adequacy (Kt/V), Median (Min-Max)	1.3 (0.5–1.7)
Laboratory results
Haemoglobin (g/dL), Mean ± SD	9.7 ± 1.3
Albumin (gr/dL), Mean ± SD	3.93 ± 0.31
TIBC (µg/dL), Mean ± SD	216 ± 45
Kreatinin pre-HD (mg/dL), Mean ± SD	13.4 ± 3.4
MIS, Median (Min-Max)	6 (2–11)
Good nutritional condition (MIS < 5)	63 (47.7)
Poor nutritional condition (MIS > 5)	69 (52.3)
SCI (mg/kg/day), Mean ± SD	24.5 ± 3.2

Notes: BMI is presented as numerical variable. Mean of BMI is within normal categories both in WHO and Asia Pacific BMI categories.

Figure 3 Subject selection process.

Figure 4 (A) Correlations analysis between SCI and MIS in stage 5 CKD patients on maintenance HD; (B) Dot plot SCI Distribution between Good and Poor Nutritional Condition.

Table 2 SCI Cut-off Value as a Predictor of Malnutrition Based on MIS

	Cut-off SCI (mg/kg/day)	Poor nutritional (MIS > 5) n=69	Good nutritional (MIS ≤ 5) n=63	Sensitivity	Specificity	PPV	NPV	+LR	-LR
High Sensitivity	≤25.77	63	30	91.3%	52.4%	67.7%	84.6%	1.92	0.17
	≤ 25.11	57	22	82.6%	65.1%	72.2%	77.4%	2.37	0.27
Optimal	≤24.53	53	13	76.8%	79.4%	80.3%	75.8%	3.72	0.29
High Specificity	≤ 23.86	45	11	65.2%	82.5%	80.4%	68.4%	3.74	0.42
	≤23.09	36	6	52.2%	90.5%	85.7%	63.3%	5.48	0.53

Abbreviations: PPV=Positive Predictive Value, NPV=Negative Predictive Value, +LR=Positive Likelihood Ratio, -LR=Negative Likelihood Ratio.

Figure 5 Optimal SCI ROC curve as a predictor of Malnutrition.