Table 3 Components of the malnutrition inflammation score (MIS)
Malnutrition Inflammation Score | |||
|---|---|---|---|
(A) Patient’s related medical history | |||
1- Change in end dialysis dry weight history: | |||
0 | 1 | 2 | 3 |
No decrease in dry weight or weight loss <0.5 kg | Minor weight loss (≥0.5 kg but <1 kg) | Weight loss more than 1 kg but <5 % | Weight loss >5 % |
2- Dietary intake: | |||
0 | 1 | 2 | 3 |
Good appetite and no deterioration of the dietary intake pattern | Somewhat sub-optimal solid diet intake | Moderate overall decrease to full liquid diet | Hypo-caloric liquid to starvation |
3- Gastrointestinal (GI) symptoms: | |||
0 | 1 | 2 | 3 |
No symptoms with good appetite | Mild symptoms, poor appetite or nauseated occasionally | Occasional vomiting or moderate GI symptoms | Frequent diarrhea or vomiting or severe anorexia |
4- Functional capacity (nutritionally related functional impairment): | |||
0 | 1 | 2 | 3 |
Normal to improved functional capacity, feeling fine | Occasional difficulty with baseline ambulation, or feeling tired frequently | Difficulty with otherwise independent activities (e.g., going to the bathroom) | Bed/chair-ridden, or little to no physical activity |
5- Comorbidity including number of years on dialysis: | |||
0 | 1 | 2 | 3 |
On dialysis less than 1 year and healthy otherwise | Dialyzed for 1–4 years, or mild comorbidity (excluding MCCa) | Dialyzed >4 years, or moderate comorbidity (including one MCCa) | Any severe, multiple comorbidity (2 or more MCCa) |
(B) Physical exam (according to SGA criteria): | |||
6- Decrease fat stores or loss of subcutaneous fat (below eyes, triceps, biceps, chest): | |||
0 | 1 | 2 | 3 |
Normal (no change) | Mild | Moderate | Severe |
7- Signs of muscle wasting (temple, clavicle, scapula, ribs, quadriceps, knee, interosseous): | |||
0 | 1 | 2 | 3 |
Normal (no change) | Mild | Moderate | Severe |
(C) Body mass index: | |||
8- Body mass index: BMI = Wt (kg)/Ht2 (m) | |||
0 | 1 | 2 | 3 |
BMI ≥20 kg/m2 | BMI 18–19.99 kg/m2 | BMI 16–17.99 kg/m2 | BMI <16 kg/m2 |
(D) Laboratory parameters: | |||
9- Serum albumin: | |||
0 | 1 | 2 | 3 |
Albumin ≥4.0 g/dL | Albumin 3.5–3.9 g/dL | Albumin 3.0–3.4 g/dL | Albumin <3.0 g/dL |
10- Serum TIBC (total iron-binding capacity): ♣ | |||
0 | 1 | 2 | 3 |
TIBC ≥250 mg/dL | TIBC 200–249 mg/dL | TIBC 150–199 mg/dL | TIBC <150 mg/dL |
Total score = sum of above 10 components (0–30) | |||