Comparison of the malnutrition–inflammation score in chronic kidney disease patients and kidney transplant recipients

Miklos Z. Molnar, Juan J. Carrero, Istvan Mucsi, Adam Remport, Connie M. Rhee, Kamyar Kalantar-Zadeh, Csaba Kovesdy, Antonio C. Cordeiro

Research output: Contribution to journalArticle

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Abstract

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 m2. 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.

Original languageEnglish (US)
Pages (from-to)1025-1033
Number of pages9
JournalInternational Urology and Nephrology
Volume47
Issue number6
DOIs
StatePublished - Jun 28 2015

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Chronic Renal Insufficiency
Glomerular Filtration Rate
Kidney
Waist Circumference
Serum Albumin
Risk Adjustment
Diagnosis-Related Groups
Leptin
Population
Transplant Recipients
Dialysis
Linear Models
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Urology

Cite this

Molnar, M. Z., Carrero, J. J., Mucsi, I., Remport, A., Rhee, C. M., Kalantar-Zadeh, K., ... Cordeiro, A. C. (2015). Comparison of the malnutrition–inflammation score in chronic kidney disease patients and kidney transplant recipients. International Urology and Nephrology, 47(6), 1025-1033. https://doi.org/10.1007/s11255-015-0984-2

Comparison of the malnutrition–inflammation score in chronic kidney disease patients and kidney transplant recipients. / Molnar, Miklos Z.; Carrero, Juan J.; Mucsi, Istvan; Remport, Adam; Rhee, Connie M.; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba; Cordeiro, Antonio C.

In: International Urology and Nephrology, Vol. 47, No. 6, 28.06.2015, p. 1025-1033.

Research output: Contribution to journalArticle

Molnar, Miklos Z. ; Carrero, Juan J. ; Mucsi, Istvan ; Remport, Adam ; Rhee, Connie M. ; Kalantar-Zadeh, Kamyar ; Kovesdy, Csaba ; Cordeiro, Antonio C. / Comparison of the malnutrition–inflammation score in chronic kidney disease patients and kidney transplant recipients. In: International Urology and Nephrology. 2015 ; Vol. 47, No. 6. pp. 1025-1033.
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abstract = "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 m2. 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.",
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AU - Molnar, Miklos Z.

AU - Carrero, Juan J.

AU - Mucsi, Istvan

AU - Remport, Adam

AU - Rhee, Connie M.

AU - Kalantar-Zadeh, Kamyar

AU - Kovesdy, Csaba

AU - Cordeiro, Antonio C.

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N2 - 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 m2. 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.

AB - 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 m2. 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.

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