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

Miklos Z. Molnar, Maria E. Czira, Anna Rudas, Akos Ujszaszi, Bela Haromszeki, Janos P. Kosa, Peter Lakatos, Gabriella Beko, Eniko Sarvary, Marina Varga, Katalin Fornadi, Marta Novak, Laszlo Rosivall, Istvan Kiss, Adam Remport, David J. Goldsmith, Csaba Kovesdy, Istvan Mucsi

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Abstract

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 m2.

Original languageEnglish (US)
Pages (from-to)2000-2006
Number of pages7
JournalNephrology Dialysis Transplantation
Volume26
Issue number6
DOIs
StatePublished - Jun 1 2011

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Malnutrition
Anemia
Inflammation
Transplants
Glomerular Filtration Rate
Leptin
Serum
Kidney
Serum Albumin
Linear Models
Interleukin-6
Hemoglobins
Lymphotoxin-beta
Wasting Syndrome
Transferrin
Erythropoietin
Nutritional Status
C-Reactive Protein
Dialysis
Proteins

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Molnar, M. Z., Czira, M. E., Rudas, A., Ujszaszi, A., Haromszeki, B., Kosa, J. P., ... Mucsi, I. (2011). Association between the malnutrition-inflammation score and post-transplant anaemia. Nephrology Dialysis Transplantation, 26(6), 2000-2006. https://doi.org/10.1093/ndt/gfq690

Association between the malnutrition-inflammation score and post-transplant anaemia. / Molnar, Miklos Z.; Czira, Maria E.; Rudas, Anna; Ujszaszi, Akos; Haromszeki, Bela; Kosa, Janos P.; Lakatos, Peter; Beko, Gabriella; Sarvary, Eniko; Varga, Marina; Fornadi, Katalin; Novak, Marta; Rosivall, Laszlo; Kiss, Istvan; Remport, Adam; Goldsmith, David J.; Kovesdy, Csaba; Mucsi, Istvan.

In: Nephrology Dialysis Transplantation, Vol. 26, No. 6, 01.06.2011, p. 2000-2006.

Research output: Contribution to journalArticle

Molnar, MZ, Czira, ME, Rudas, A, Ujszaszi, A, Haromszeki, B, Kosa, JP, Lakatos, P, Beko, G, Sarvary, E, Varga, M, Fornadi, K, Novak, M, Rosivall, L, Kiss, I, Remport, A, Goldsmith, DJ, Kovesdy, C & Mucsi, I 2011, 'Association between the malnutrition-inflammation score and post-transplant anaemia', Nephrology Dialysis Transplantation, vol. 26, no. 6, pp. 2000-2006. https://doi.org/10.1093/ndt/gfq690
Molnar MZ, Czira ME, Rudas A, Ujszaszi A, Haromszeki B, Kosa JP et al. Association between the malnutrition-inflammation score and post-transplant anaemia. Nephrology Dialysis Transplantation. 2011 Jun 1;26(6):2000-2006. https://doi.org/10.1093/ndt/gfq690
Molnar, Miklos Z. ; Czira, Maria E. ; Rudas, Anna ; Ujszaszi, Akos ; Haromszeki, Bela ; Kosa, Janos P. ; Lakatos, Peter ; Beko, Gabriella ; Sarvary, Eniko ; Varga, Marina ; Fornadi, Katalin ; Novak, Marta ; Rosivall, Laszlo ; Kiss, Istvan ; Remport, Adam ; Goldsmith, David J. ; Kovesdy, Csaba ; Mucsi, Istvan. / Association between the malnutrition-inflammation score and post-transplant anaemia. In: Nephrology Dialysis Transplantation. 2011 ; Vol. 26, No. 6. pp. 2000-2006.
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abstract = "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 m2.",
author = "Molnar, {Miklos Z.} and Czira, {Maria E.} and Anna Rudas and Akos Ujszaszi and Bela Haromszeki and Kosa, {Janos P.} and Peter Lakatos and Gabriella Beko and Eniko Sarvary and Marina Varga and Katalin Fornadi and Marta Novak and Laszlo Rosivall and Istvan Kiss and Adam Remport and Goldsmith, {David J.} and Csaba Kovesdy and Istvan Mucsi",
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T1 - Association between the malnutrition-inflammation score and post-transplant anaemia

AU - Molnar, Miklos Z.

AU - Czira, Maria E.

AU - Rudas, Anna

AU - Ujszaszi, Akos

AU - Haromszeki, Bela

AU - Kosa, Janos P.

AU - Lakatos, Peter

AU - Beko, Gabriella

AU - Sarvary, Eniko

AU - Varga, Marina

AU - Fornadi, Katalin

AU - Novak, Marta

AU - Rosivall, Laszlo

AU - Kiss, Istvan

AU - Remport, Adam

AU - Goldsmith, David J.

AU - Kovesdy, Csaba

AU - Mucsi, Istvan

PY - 2011/6/1

Y1 - 2011/6/1

N2 - 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 m2.

AB - 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 m2.

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