Evaluation of the malnutrition-inflammation score in kidney transplant recipients.
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.
Molnar
Miklos Zsolt
MZ
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary; Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary. molnar@medformol.hu
Keszei
Andras
A
Czira
Maria Eszter
ME
Rudas
Anna
A
Ujszaszi
Akos
A
Haromszeki
Bela
B
Kosa
Janos Pal
JP
Lakatos
Peter
P
Sarvary
Eniko
E
Beko
Gabriella
G
Fornadi
Katalin
K
Kiss
Istvan
I
Remport
Adam
A
Novak
Marta
M
Kalantar-Zadeh
Kamyar
K
Kovesdy
Csaba P
CP
Mucsi
Istvan
I
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