Comparison of the malnutrition-inflammation score in chronic kidney disease patients and kidney transplant recipients.
BACKGROUND
Protein-energy wasting (PEW) is a common condition in patients with chronic kidney disease (CKD) including dialysis and kidney transplant recipients (TX) and frequently assessed with malnutrition-inflammation score (MIS). We hypothesized that (1) the MIS and PEW parameters are correlated with kidney function and (2) the MIS and PEW parameters are more severe in TX than in non-dialysis (ND) CKD patients with similar eGFR.


METHODS
In this study, we matched 203 ND-CKD and 203 TX patients from two independently assembled cohorts of patients based on estimated glomerular filtration rate (eGFR) and compared various PEW parameters between the two groups using unadjusted and case-mix adjusted linear regression and conditional logistic regression analysis models.


RESULTS
In the combined cohort (n = 406) of patients, the mean ± SD age was 57 ± 12 years; included 55 % men and 35 % diabetics; and demonstrated a mean ± SD baseline eGFR of 29 ± 11 ml/min/1.73 m(2). The eGFR correlated positively with serum albumin (ρ = 0.26, p < 0.001) and negatively (ρ = -0.33, p < 0.001) with MIS. ND-CKD and TX patients had similar MIS, PEW parameters such as waist circumference, serum CRP, albumin, and leptin levels. After case-mix adjustment, TX status was associated with higher waist circumference (standardized coefficient: 0.187, p < 0.001), lower BMI (standardized coefficient: -0.204, p < 0.001), and lower SGA score (standardized coefficient: 0.156, p = 0.006).


CONCLUSIONS
We found associations between lower eGFR and various PEW measures in both the ND-CKD and TX populations. Additionally, we did not observe significant differences in the burden of PEW parameters between the CKD and TX populations.
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, 956 Court Ave., Room B216B, Memphis, TN, 38103, USA, mzmolnar@uthsc.edu.
Miklos Z
MZ
Molnar
Juan J
JJ
Carrero
Istvan
I
Mucsi
Adam
A
Remport
Connie M
CM
Rhee
Kamyar
K
Kalantar-Zadeh
Csaba P
CP
Kovesdy
Antonio C
AC
Cordeiro
D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011502:Protein-Energy Malnutrition / Q000209:etiology*; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012720:Severity of Illness Index