Abstract: SA-PO662
Association Between Malnutrition-Inflammation Complex Syndrome (MICS) and the Risk for Bone-Vascular Events in Patients Receiving Maintenance Hemodialysis: The Q-Cohort Study
Session Information
- Bone and Mineral Metabolism: Clinical - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Yamada, Shunsuke, Kyushu University, Fukuoka, Japan
- Arase, Hokuto, Kyushu University, Fukuoka, Japan
- Tokumoto, Masanori, Department of Internal Medicine, Fukuoka Dental College, Sawara-ku, Fukuoka, Japan
- Taniguchi, Masatomo, Fukuoka Renal Clinic, Fukuoka, Japan
- Yoshida, Hisako, Osaka City University Graduate School of Medicine, Osaka, Japan
- Tsuruya, Kazuhiko, Nara Medical University, Kashihara, Japan
- Nakano, Toshiaki, Kyushu University, Fukuoka, Japan
- Kitazono, Takanari, Kyushu University, Fukuoka, Japan
Background
Malnutrition-inflammation complex syndrome (MICS) is highly prevalent in hemodialysis patients and increases the risk for morbidity and mortality. MICS is supposed to affect bone-vascular system. However, it is unknown whether MICS increases the risk for both bone fracture and cardiovascular events in maintenance hemodialysis patients. To determine the association between MICS and those risks, we analyzed the data of the Q-Cohort Study, a multicenter, prospective, observational study.
Methods
A total of 2887 hemodialysis patients were included in the analysis. As a simple indicator for MICS, we newly developed a score (0-12) reflecting MICS by semi-quantitatively scaling the following five baseline parameters and adding up the scores of each parameters; age (0-3), serum levels of albumin (0-3), creatinine (0-3), and C-reactive protein (0-2), and body mass index (0-1). The main outcomes were the incidence of bone fracture, cardiovascular events, and all-cause death. The main exposure was MICS score. Patients were divided into four groups based on the MICS score; 0-3, 4-5, 6-8, and 9-12). Risk estimates for each outcome were calculated by Cox proportional hazards model with multivariable adjustments.
Results
During the median follow-up period of four years, 134 patients developed bone fracture, 519 patients developed cardiovascular events, and 482 patients died of any cause. The average MICS score was 5.16. Patients in the highest MICS score group (9-12) showed an increased risk for bone fracture, cardiovascular events, and all-cause mortality (HR [95%CI]; 2.14 [1.08–4.02], 2.17 [1.52–2.96], and 5.07 [3.37–7.63], respectively) compared with the lowest MICS score group (0-3). We also confirmed the internal validity of our MICS score by applying bootstrap resampling. A principal analysis also confirmed that the five parameters of the MICS score increased the risk for the three outcomes examined in our patients.
Conclusion
A higher MICS score was associated with the increased risk for bone fracture and cardiovascular events in patients receiving hemodialysis.