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Multicenter Study
. 2025 Jul 1;26(1):305.
doi: 10.1186/s12882-025-04089-0.

The association of Malnutrition-Inflammation Score with sleep quality and mental health in hemodialysis patients: a multicenter cross-sectional study

Mehrnaz Morvaridi  1 , Hossein Bavi Behbahani  2   3 , Meysam Alipour  4 , Ahmad Zare Javid  5 , Sara Keramatzadeh  6 , Shiva Shokri  7 , Pardis Tofighzadeh  6 , Fatemeh Fayazfar  7 , Haleh Soltaniyan Dehkordi  8 , Elahe Ghadimi  5 , Siavash Babajafari Esfandabad  9 , Shokouh Shayanpour  10
Affiliations
Multicenter Study

The association of Malnutrition-Inflammation Score with sleep quality and mental health in hemodialysis patients: a multicenter cross-sectional study

Mehrnaz Morvaridi et al. BMC Nephrol. .

Abstract

Background: Hemodialysis is crucial for individuals with end-stage renal disease (ESRD), but it poses challenges that impact health and quality of life. Malnutrition, inflammation, sleep disturbances, and mental health disorders are common among hemodialysis patients, interconnecting and influencing outcomes. Therefore, the study aimed to investigate the association between the Malnutrition-Inflammation Score (MIS) and various health parameters, including sleep quality and mental health in hemodialysis patients.

Methods: A multicenter cross-sectional study investigated the association between the MIS and health parameters in 423 hemodialysis patients across eight centers. Assessments included MIS, physical activity levels, dietary intake, sleep quality, and mental health status, along with biochemical parameters. Statistical analyses using SPSS software were conducted to identify associations.

Results: Significant differences were observed in demographic, clinical, and biochemical characteristics across MIS quartiles (p < .05). Older age, lower BMI, longer dialysis vintage, and altered biochemical profiles were noted in higher MIS quartiles. Depression scores were significantly higher in higher MIS quartiles (p = .04). Multivariable analyses confirmed these associations, indicating higher odds of poorer sleep quality, depression, and anxiety with increasing MIS quartiles (p < .05).

Conclusion: The study highlights the intricate association between malnutrition, inflammation, sleep quality, and mental health conditions in hemodialysis patients. Addressing these factors comprehensively and tailoring interventions may lead to improved outcomes and well-being.

Keywords: Hemodialysis; Inflammation; Malnutrition; Mental health; Sleep quality.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and was approved by the Shoushtar University of Medical Sciences and Health Services (Approval Number: IR.SHOUSHTAR.REC.1403.019). Written informed consent was obtained from all participants before enrollment in the study. Patients were provided with detailed information about the study objectives, procedures, potential risks, and benefits, and they had the opportunity to ask questions before providing consent. Participation was entirely voluntary, and participants were assured of their right to withdraw from the study at any time without consequences for their medical care. Confidentiality and data privacy were strictly maintained throughout the study, with all personal information anonymized and securely stored. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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References

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