title: Quality of life and protein-energy wasting in kidney transplant recipients.
abstract: OBJECTIVE
  Chronic kidney disease has profound effects on the health-related quality of life (HRQoL) of patients, with serious physiological, psychological and socio-economic implications. The co-occurrence of protein-energy wasting and inflammation in end-stage renal disease patients is associated with worse HRQoL and increased mortality. We designed this study to examine the relationship between nutritional and inflammatory status and HRQoL in kidney transplant recipients.
  
  
  METHODS
  Data from 100 randomly selected kidney transplant patients were analyzed in a cross-sectional survey. Socio-demographic parameters, laboratory results, transplantation-related data, comorbidities, medication and malnutrition-inflammation score (MIS) (Kalantar Score) were tabulated at baseline. Patients completed the Kidney Disease Quality of Life-SF (KDQoL-SF™) self-administered questionnaire.
  
  
  RESULTS
  Mean age was 51 ± 13 years, median (interquartile range, IQR) time since transplantation 66 (83) months, 57% were men, and 19% had diabetes. The median (IQR) MIS was 3 (3). The MIS significantly and negatively correlated with almost all HRQoL domains analyzed, and this association remained significant in multivariate linear regression analysis for the log-transformed scores on energy/fatigue (β = -0.059 P < 0.001), bodily pain (β = -0.056 P = 0.004), physical functioning (β = -0.029, P = 0.022) and symptoms/problems (β = -0.023 P = 0.005) domains after statistical correction for age, gender, eGFR, dialysis vintage, Charlson Comorbidity Index and occupational status. Additionally, cubic spline analyses revealed linearly increasing, "dose-response" relationship between almost all domains of KDQoL-SF™ and the MIS.
  
  
  CONCLUSIONS
  Malnutrition-inflammation score is independently associated with different dimensions of HRQoL in kidney transplant recipients.
authors.affiliation: Institute of Pathophysiology, Semmelweis University, Nagyvarad ter 4, 1089 Budapest, Hungary.
authors.forename: Akos
authors.initials: A
authors.lastname: Ujszaszi
authors.forename: Maria E
authors.initials: ME
authors.lastname: Czira
authors.forename: Katalin
authors.initials: K
authors.lastname: Fornadi
authors.forename: Marta
authors.initials: M
authors.lastname: Novak
authors.forename: Istvan
authors.initials: I
authors.lastname: Mucsi
authors.forename: Miklos Z
authors.initials: MZ
authors.lastname: Molnar
mesh_terms: D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D008875:Middle Aged; D011506:Proteins / Q000378:metabolism*; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D011506:Proteins