Association between the malnutrition-inflammation score and post-transplant anaemia.
BACKGROUND
Post-transplant anaemia (PTA) is common and is associated with adverse consequences. The protein-energy wasting (PEW) syndrome is associated with erythropoietin resistance in patients on maintenance dialysis. We assessed the association between PEW and PTA in a large prevalent cohort of stable kidney-transplanted patients.


METHODS
Data from 942 prevalent kidney-transplanted patients were analysed. Socio-demographic parameters, laboratory results, transplantation-related data and medication were obtained from the charts. Biomarkers reflecting nutritional status and inflammation [serum leptin, albumin, interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and C-reactive protein] were measured. Anthropometric measures and the malnutrition-inflammation score (MIS) were also tabulated. Anaemia was defined according to the guidelines of the American Society of Transplantation.


RESULTS
Mean age was 51 ± 13 years, 57% were males and 22% had diabetes. The prevalence of PTA was 33%. The haemoglobin (Hb) level significantly and negatively correlated with the MIS (rho = - 0.316), marginally with serum TNF-α (rho = - 0.079) and serum IL-6 (rho = - 0.075) and positively with serum transferrin (r = 0.298), serum albumin (r = 0.274), abdominal circumference (r = 0.254) and serum leptin (rho = - 0.152), P < 0.05 for all. In a multivariable linear regression model, MIS was independently associated with Hb (beta = - 0.118, P = 0.004) in patients with estimated glomerular filtration rate (eGFR) lower than or equal to 60 mL/min/1.73 m(2), but not in patients with higher eGFR.


CONCLUSIONS
The MIS is independently associated with PTA in the kidney-transplanted population with eGFR lower than or equal to 60 mL/min/1.73 m(2).
Institute of Pathophysiology, Semmelweis University, Budapest, Hungary. molnar@medformol.hu
Miklos Z
MZ
Molnar
Maria E
ME
Czira
Anna
A
Rudas
Akos
A
Ujszaszi
Bela
B
Haromszeki
Janos P
JP
Kosa
Peter
P
Lakatos
Gabriella
G
Beko
Eniko
E
Sarvary
Marina
M
Varga
Katalin
K
Fornadi
Marta
M
Novak
Laszlo
L
Rosivall
Istvan
I
Kiss
Adam
A
Remport
David J
DJ
Goldsmith
Csaba P
CP
Kovesdy
Istvan
I
Mucsi
D000368:Aged; D000740:Anemia / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D044342:Malnutrition / Q000209:etiology*; D008875:Middle Aged; D009752:Nutritional Status; D011379:Prognosis; D015996:Survival Rate; D019282:Wasting Syndrome / Q000209:etiology*