There is now good evidence that many hemodialysis patients are affected by low protein status (here defined as albumin < 3.8g/dL) and elevated inflammation (here defined as CRP > 10 mg/L [in Japan: CRP > 3 mg/L]). If both occur together, this forms a so-called malnutrition-inflammation complex (MIC).
Another problem observed in many hemodialysis patients is low functional status (FS).
A recent article by Kanda et al. (2021; Scientific Reports) investigated the association of MIC and FS combinations with mortality (risk to die) in hemodialysis patients from various countries.
Key outcome of the study is summarized below.
In a nutshell, both the presence of MIC (Mic (+)) and low FS significantly increase the risk to die; if both factors occur together, the risk is even further increased to more than 3-fold (after adjusting the model for several parameters).
From a personal perspective, this study again highlights the importance of sufficient dietary protein intake as well as focusing on a training regime of endurance and weight exercise to avoid muscle loss (sarcopenia) and frailty.
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