{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:18:59Z","timestamp":1790313539634,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,7,9]],"date-time":"2023-07-09T00:00:00Z","timestamp":1688860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Patients with end stage kidney disease undergoing maintenance hemodialysis (MHD) are prone to malnutrition and infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to evaluate the effect of polymorphonuclear (PMN) cell dysfunction on clinical outcomes of MHD patients, in association with nutritional status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective study investigated 39 MHD patients by evaluating the oxidative activity of their PMN cells using Phorbol 12\u2010Myristate\u201013\u2010Acetate (PMA) stimulation. Blood samples were taken from each participant at dialysis initiation. Demographics, laboratory data, and clinical outcomes during a 24\u2010month follow\u2010up period were obtained from electronic medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Phagocytic activity was described in percentiles of mean fluorescence intensity (MFI) of PMA levels. There were no differences in comorbidities between patients with low or high MFI\u2010PMA percentiles. Patients in the lowest (25th) MFI\u2010PMA percentile (<jats:italic>N<\/jats:italic>\u2009=\u200910) had poorer nutritional status and more frequent severe infections compared to the other 29 patients (4.3\u2009\u00b1\u20093.4 events versus 2\u2009\u00b1\u20092.2 events, <jats:italic>p<\/jats:italic>\u2009=\u20090.017). Furthermore, they had more frequent hospitalizations (&gt;3) due to infections (70% versus 41%, <jats:italic>p<\/jats:italic>\u2009=\u20090.073) and their mortality rate was higher (80% versus 31%, <jats:italic>p<\/jats:italic>\u2009=\u20090.007). The odds ratio for all\u2010cause mortality was 8.85. In multivariate analysis, the MFI\u2010PMA percentile and ischemic heart disease were the strongest predictors of all\u2010cause mortality (<jats:italic>p<\/jats:italic>\u2009=\u20090.02 and <jats:italic>p<\/jats:italic>\u2009=\u20090.005, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low MFI\u2010PMA levels were associated with poor nutritional status and adverse clinical outcomes and might serve as a prognostic biomarker, predicting severe infections and mortality among malnourished MHD patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/sdi.13168","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T03:10:02Z","timestamp":1688958602000},"page":"399-406","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neutrophil reactive oxygen formation, bacterial infections and mortality in malnourished hemodialysis patients: Evaluation of clinical outcomes"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8227-5360","authenticated-orcid":false,"given":"Hadar","family":"Mudrik\u2010Zohar","sequence":"first","affiliation":[{"name":"Department of Internal Medicine A Meir Medical Center  Kfar Saba Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny","family":"Alon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine A Meir Medical Center  Kfar Saba Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Nacasch","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Department of Nephrology and Hypertension Meir Medical Center  Kfar Saba 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