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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
The malnutrition–inflammation complex/cachexia syndrome (MICS) is a condition in chronic kidney disease (CKD) patients characterized by concurrent protein–energy wasting and persistent inflammation, leading to muscle loss and poor clinical outcomes. MICS is common among maintenance hemodialysis (HD) patients and is associated with adverse prognoses. Although infection is a major cause of death in this population, few studies have investigated the association between infection-related mortality and nutritional status assessed by a comprehensive nutrition assessment tool.
We analyzed 3,036 HD patients aged ≥18 years from the Q-Cohort Study (2006–2010) with complete baseline data. The primary exposure was the MICS score, derived from five parameters—age, body mass index, and serum albumin, creatinine, and C-reactive protein levels—as previously described (Yamada S et al., Kidney Med, 2022). Higher scores indicate greater undernutrition and inflammation. Patients were divided into quartiles (Q1–Q4) according to baseline MICS scores. The primary outcome was infection-related death. Covariates included demographics, dialysis vintage and duration, diabetic nephropathy, cardiovascular disease, mineral metabolism markers, and use of phosphate binders or vitamin D receptor activators. Survival analyses employed Kaplan–Meier curves, Cox proportional hazards models, and Fine–Gray competing risk regression.
During 10 years of follow-up, 107 infection-related deaths occurred. The median MICS score was 196, with quartile ranges of Q1 (116–181), Q2 (182–196), Q3 (197–211), and Q4 (212–294). Higher quartiles (Q3 and Q4) showed markedly increased infection-related mortality compared with Q1. In adjusted Cox models, hazard ratios for infection-related death were 3.68 (95% CI, 1.15–11.78) for Q3 and 11.63 (95% CI, 3.39–39.88) versus Q1. In the Fine–Gray model, elevated MICS scores remained significantly associated with infection-related mortality after multivariable adjustment (Q3: HR 4.07, 95% CI 1.30–12.72; Q4: HR 12.01, 95% CI 3.65–39.52). Restricted cubic spline analysis demonstrated a nonlinear dose–response relationship, with progressively higher risk at higher MICS scores. Subgroup analyses revealed that elevated MICS scores were associated with increased infection-related mortality among patients without diabetic nephropathy (HR 2.14, 95% CI 1.75–2.65), whereas no significant association was observed in those with diabetic nephropathy.
The MICS score, integrating nutritional and inflammatory markers, independently predicts infection-related mortality in HD patients. These findings underscore its value as a robust prognostic tool for risk stratification and may inform strategies to improve infection-related outcomes in this vulnerable population.
