Association between inflammatory potential of diet and markers of malnutrition in haemodialysis patients

In this study, we aimed to examine the relationship between energy-adjusted dietary inflammatory index (E-DII) and a comprehensive profile of malnutrition in Iranian haemodialysis (HD) patients. In this cross-sectional study, 291 participants on HD for at least 6 months before enrollment were included. The current dietary intakes of participants were assessed using a 4-d diet diary-assisted recall, including 2 non-dialysis days and 2 dialysis days to calculate E-DII. To determine the malnutrition status of HD patients, BMI, subjective global assessment (SGA), dialysis malnutrition score (DMS) and malnutrition inflammation score (MIS) were used. Overall, 291 HD patients comprised our study population. After controlling for potential confounders, E-DII was associated with a higher risk of malnutrition, as evidenced by SGA (OR = 2 center dot 23; 95 % CI: 1 center dot 11, 4 center dot 49), DMS (OR = 2 center dot 31; 95 % CI: 1 center dot 16, 4 center dot 60) and MIS (OR = 2 center dot 50; 95 % CI: 1 center dot 28, 4 center dot 88). No significant association was detected between E-DII and BMI either before (OR = 1 center dot 78; 95 % CI: 0 center dot 83, 3 center dot 81) or after adjustment for possible confounders (OR = 1 center dot 43; 95 % CI: 0 center dot 58, 3 center dot 54). This study showed that E-DII was significantly associated with reliable malnutrition markers including SGA, DMS and MIS in HD patients. However, further longitudinal studies are warranted to infer a cause-and-effect relationship between DII and malnutrition.