Association Between Malnutrition–Inflammation Score and Health-Related Quality of Life Across KDQOL-36 Domains in Hemodialysis Patients

Abstract

Malnutrition–inflammation is common among patients receiving maintenance hemodialysis and may adversely affect health-related quality of life (HRQoL). This analytical cross-sectional study included 100 adult patients receiving maintenance hemodialysis at Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia. Malnutrition–inflammation status was assessed using the Malnutrition–Inflammation Score (MIS), while HRQoL was evaluated using the Bahasa Indonesia version of the Kidney Disease Quality of Life-36 (KDQOL-36), comprising the Physical Component Summary (PCS), Mental Component Summary (MCS), Symptoms/Problems of Kidney Disease (SPKD), Effects of Kidney Disease (EKD), and Burden of Kidney Disease (BKD). Associations were examined using Spearman correlation and multivariable linear regression adjusted for age, sex, education, and occupation. Higher MIS was significantly associated with lower scores across all KDQOL-36 domains: PCS (ρ=−0.342; p=0.001), MCS (ρ=−0.315; p=0.001), SPKD (ρ=−0.288; p=0.004), EKD (ρ=−0.263; p=0.008), and BKD (ρ=−0.270; p=0.007). In multivariable analyses, MIS remained significantly associated with each HRQoL domain after adjustment for sociodemographic factors, although the overall BKD model did not reach statistical significance. These findings indicate that greater malnutrition–inflammation burden is consistently associated with poorer physical, mental, symptom-related, disease-effect, and disease-burden dimensions of HRQoL in patients receiving hemodialysis.