Association between the malnutrition-inflammation score and post-transplant anaemia

被引:43
作者
Molnar, Miklos Z. [1 ,2 ,3 ]
Czira, Maria E. [2 ]
Rudas, Anna [1 ]
Ujszaszi, Akos [1 ]
Haromszeki, Bela [1 ]
Kosa, Janos P. [4 ]
Lakatos, Peter [4 ]
Beko, Gabriella [5 ]
Sarvary, Eniko [6 ]
Varga, Marina [6 ]
Fornadi, Katalin [2 ,7 ]
Novak, Marta [2 ]
Rosivall, Laszlo [1 ,8 ,9 ]
Kiss, Istvan [10 ]
Remport, Adam [10 ]
Goldsmith, David J. [11 ]
Kovesdy, Csaba P. [12 ,13 ]
Mucsi, Istvan [2 ,14 ]
机构
[1] Semmelweis Univ, Inst Pathophysiol, H-1085 Budapest, Hungary
[2] Semmelweis Univ, Inst Behav Sci, H-1085 Budapest, Hungary
[3] Harbor UCLA Med Ctr, Los Angeles Biomed Res Inst, Harold Simmons Ctr Chron Dis Res & Epidemiol, Torrance, CA 90509 USA
[4] Semmelweis Univ, Dept Internal Med 1, H-1085 Budapest, Hungary
[5] Semmelweis Univ, Cent Lab, H-1085 Budapest, Hungary
[6] Semmelweis Univ, Dept Transplantat & Surg, H-1085 Budapest, Hungary
[7] Semmelweis Univ, Dept Neurol, H-1085 Budapest, Hungary
[8] Semmelweis Univ, Res Grp Pediat & Nephrol, H-1085 Budapest, Hungary
[9] Hungarian Acad Sci, Budapest, Hungary
[10] Szent Imre Hosp, Dept Nephrol, Budapest, Hungary
[11] Guys Hosp, Renal Unit, London SE1 9RT, England
[12] Salem VA Med Ctr, Div Nephrol, Salem, VA USA
[13] Univ Virginia, Div Nephrol, Charlottesville, VA USA
[14] McGill Univ, Dept Med, Ctr Hlth, Div Nephrol, Montreal, PQ, Canada
关键词
inflammation; kidney transplantation; post-transplant anaemia; protein-energy wasting; RENAL-TRANSPLANT RECIPIENTS; SUBJECTIVE GLOBAL ASSESSMENT; KIDNEY-TRANSPLANT; COMPLEX SYNDROME; HEMODIALYSIS; MORTALITY; RISK; FAILURE; SENSITIVITY; PREVALENCE;
D O I
10.1093/ndt/gfq690
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
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-alpha (TNF-alpha) 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-alpha (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).
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页码:2000 / 2006
页数:7
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