title: Evaluation of the malnutrition-inflammation score in kidney transplant recipients.
abstract: BACKGROUND
  Chronic protein-energy wasting, termed malnutrition-inflammation complex syndrome, is frequent in patients with chronic kidney disease and is associated with anemia, morbidity, and mortality in patients on maintenance dialysis therapy. The Malnutrition-Inflammation Score (MIS) recently has been developed and validated in dialysis patients.
  
  
  METHODS
  Observational cross-sectional study.
  
  
  METHODS
  993 prevalent kidney transplant recipients.
  
  
  METHODS
  MIS computed from change in body weight, dietary intake, gastrointestinal symptoms, functional capacity, comorbid conditions, decreased fat store/Systemic Global Assessment, signs of muscle wasting/Systemic Global Assessment, body mass index, serum albumin level, and serum transferrin level.
  
  
  RESULTS
  Markers of inflammation and malnutrition, including serum C-reactive protein, interleukin 6, tumor necrosis factor alpha, serum leptin, prealbumin, body mass index, and abdominal circumference. The relationship was modeled by using structural equation models.
  
  
  RESULTS
  Mean age was 51 +/- 13 years, 57% were men, and 21% had diabetes. Median time from transplant was 72 months. MIS significantly correlated with abdominal circumference (r = -0.144), serum C-reactive protein level (r = 0.094), serum interleukin 6 level (r = 0.231), and serum tumor necrosis factor alpha level (r = 0.102; P < 0.01 for all). A structural equation model with 2 latent variables (malnutrition and inflammation factor) showed good fit to the observed data.
  
  
  CONCLUSIONS
  Single-center study, lack of information about vascular access, presence of nonfunctioning kidney transplant, relatively high refusal rate.
  
  
  CONCLUSIONS
  Our results confirm that MIS reflects both energy-protein wasting and inflammation in kidney transplant recipients. This simple instrument appears to be a useful tool to assess the presence of protein-energy wasting in this patient population.
authors.affiliation: Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary; Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary. molnar@medformol.hu
authors.forename: Miklos Zsolt
authors.initials: MZ
authors.lastname: Molnar
authors.forename: Andras
authors.initials: A
authors.lastname: Keszei
authors.forename: Maria Eszter
authors.initials: ME
authors.lastname: Czira
authors.forename: Anna
authors.initials: A
authors.lastname: Rudas
authors.forename: Akos
authors.initials: A
authors.lastname: Ujszaszi
authors.forename: Bela
authors.initials: B
authors.lastname: Haromszeki
authors.forename: Janos Pal
authors.initials: JP
authors.lastname: Kosa
authors.forename: Peter
authors.initials: P
authors.lastname: Lakatos
authors.forename: Eniko
authors.initials: E
authors.lastname: Sarvary
authors.forename: Gabriella
authors.initials: G
authors.lastname: Beko
authors.forename: Katalin
authors.initials: K
authors.lastname: Fornadi
authors.forename: Istvan
authors.initials: I
authors.lastname: Kiss
authors.forename: Adam
authors.initials: A
authors.lastname: Remport
authors.forename: Marta
authors.initials: M
authors.lastname: Novak
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.forename: Csaba P
authors.initials: CP
authors.lastname: Kovesdy
authors.forename: Istvan
authors.initials: I
authors.lastname: Mucsi
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000473:pathology; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D012720:Severity of Illness Index; D014180:Transplantation / Q000473:pathology