Modified creatinine index for predicting prognosis in hemodialysis patients: a systematic review and meta-analysis.

ABSTRACT

BACKGROUND: Currently, several studies have explored the association between the modified creatinine index (mCI) and prognosis in patients on hemodialysis (HD). However, some of their results are contradictory. Therefore, this study was conducted to comprehensively assess the role of mCI in predicting prognosis in HD patients through meta-analysis. METHODS: We searched and screened literature from PubMed, Embase, Web of Science, and Cochrane databases from their establishment until March 2024. Relevant data were extracted. The statistical analysis was performed using Stata 15.0, RevMan 5.4, and Meta DiSc 1.4 software. RESULTS: The results showed a positive association between mCI and nutritional status in HD patients (BMI r = 0.19, 95% CI 0.1-0.28, p = .000; albumin r = 0.36, 95% CI 0.33-0.39, p = .000; normalized protein catabolic rate (nPCR) r = 0.25, 95% CI 0.13-0.38, p = .000). In addition, mCI in deceased HD patients was significantly lower than that in HD survivors (SMD = -0.94, 95% CI -1.46 to -0.42, p = .000). A low mCI was associated with an increased risk of all-cause death in HD patients (HR = 1.95, 95% CI 1.57-2.42, p = .000). In addition, a low mCI was significantly associated with decreased overall survival (OS) in HD patients (HR = 3.01, 95% CI 2.44-3.70, p = .000). mCI showed moderate diagnostic accuracy for sarcopenia in both male and female HD patients (male AUC = 0.7891; female AUC = 0.759). CONCLUSIONS: The mCI can be used as a prognostic marker for HD patients, and monitoring mCI may help to optimize the management of HD and improve overall prognosis in patients.