Abstract
BACKGROUND: The C-reactive protein to albumin ratio (CAR) is a biomarker associated with various diseases; however, its significance in maintenance hemodialysis (MHD) patients remains unclear. This study sought to explore the relationship between the Malnutrition-Inflammation Score (MIS) and CAR in this population. METHODS: In a cross-sectional study, 231 adult MHD patients were enrolled and categorized into high (n = 98) and low (n = 133) MIS groups based on an optimala cutoff value of 7. Detailed analyses were conducted on the MIS, biochemical parameters, and other biomarker ratios to assess their relationships. RESULTS: Significant differences were observed in albumin, CRP, CAR, and RAR levels (all p < 0.05). A significant association was observed between CAR and MIS with MIS (OR 1.05, p < 0.001). The area under the receiver operating characteristic curve (AUROC) for CAR in identifying nutritional and inflammatory risk was 73.85%, with an optimal cutoff value of 2.158. A non-linear relationship was also identified between MIS and CAR. CONCLUSION: CAR is independently associated with the MIS in MHD patients and may serve as a valuable biomarker, underscoring its potential value for clinical nutritional management of this patient population.