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Pretransplant malnutrition, inflammation, and atherosclerosis affect cardiovascular outcomes after kidney transplantation.

Hwang JH, Ryu J, An JN, Kim CT, Kim H, Yang J, Ha J, Chae DW, Ahn C, Jung IM, Oh YK, Lim CS, Han DJ, Park SK, Kim YS, Kim YH, Lee JP - BMC Nephrol (2015)

Bottom Line: The patients with higher MIA score showed worse outcome of fatal/non-fatal acute coronary syndrome (ACS) (p < 0.001) and composite outcomes of ACS and all-cause mortality (p < 0.001) than with the lower MIA score.In multivariate analysis, ACS showed significantly higher incidence in the MIA score 8-10 group than in the MIA score 0 group (Hazard ratio 6.12 95 % Confidence interval 1.84-20.32 p = 0.003).The presence of MIA factors before KT is an independent predictor of post-transplant CV outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea. dennyjinho@gmail.com.

ABSTRACT

Background: Malnutrition, inflammation, and atherosclerosis (MIA) syndrome is associated with a high mortality rate in patients with end-stage renal disease. However, the clinical relevance of MIA syndrome in kidney transplantation (KT) recipients remains unknown.

Methods: We enrolled 1348 adult KT recipients. Recipients were assessed based on serum albumin, cholesterol, or body mass index for the malnutrition factor and C-reactive protein level for the inflammation factor. Any history of cardiovascular (CV), cerebrovascular, or peripheral vascular disease satisfied the atherosclerosis factor. Each MIA factors were assessed by univariate analysis and we calculated an overall risk score by summing up scores for each independent variable. The enrolled patients were divided into 4 groups depending on the MIA score (0, 2-4, 6, 8-10).

Results: The patients with higher MIA score showed worse outcome of fatal/non-fatal acute coronary syndrome (ACS) (p < 0.001) and composite outcomes of ACS and all-cause mortality (p < 0.001) than with the lower MIA score. In multivariate analysis, ACS showed significantly higher incidence in the MIA score 8-10 group than in the MIA score 0 group (Hazard ratio 6.12 95 % Confidence interval 1.84-20.32 p = 0.003).

Conclusions: The presence of MIA factors before KT is an independent predictor of post-transplant CV outcomes.

No MeSH data available.


Related in: MedlinePlus

Defining the study population. We reviewed the medical records of 2425 individuals and collected data from 1348 patients
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Fig1: Defining the study population. We reviewed the medical records of 2425 individuals and collected data from 1348 patients

Mentions: This study was performed as a retrospective, multicenter study. Among the patients in whom kidney transplantation had been performed at Seoul National University Hospital, Seoul National University Boramae Medical Center, Seoul National University Bundang Hospital, and Asan Medical Center from Jun. 1999 through Dec. 2011, we reviewed the medical records of 2425 individuals and collected data from 1348 patients. All patients were adults (age ≥ 15 years); had pretransplant CRP, serum albumin, and cholesterol data available; received renal transplants; and were followed for more than one year after transplantation (Fig. 1). Patients with a previous transplantation history and those with unavailable pretransplant laboratory profiles were excluded. Patients with a follow-up duration less than one year were also excluded from the analysis.Fig. 1


Pretransplant malnutrition, inflammation, and atherosclerosis affect cardiovascular outcomes after kidney transplantation.

Hwang JH, Ryu J, An JN, Kim CT, Kim H, Yang J, Ha J, Chae DW, Ahn C, Jung IM, Oh YK, Lim CS, Han DJ, Park SK, Kim YS, Kim YH, Lee JP - BMC Nephrol (2015)

Defining the study population. We reviewed the medical records of 2425 individuals and collected data from 1348 patients
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4508766&req=5

Fig1: Defining the study population. We reviewed the medical records of 2425 individuals and collected data from 1348 patients
Mentions: This study was performed as a retrospective, multicenter study. Among the patients in whom kidney transplantation had been performed at Seoul National University Hospital, Seoul National University Boramae Medical Center, Seoul National University Bundang Hospital, and Asan Medical Center from Jun. 1999 through Dec. 2011, we reviewed the medical records of 2425 individuals and collected data from 1348 patients. All patients were adults (age ≥ 15 years); had pretransplant CRP, serum albumin, and cholesterol data available; received renal transplants; and were followed for more than one year after transplantation (Fig. 1). Patients with a previous transplantation history and those with unavailable pretransplant laboratory profiles were excluded. Patients with a follow-up duration less than one year were also excluded from the analysis.Fig. 1

Bottom Line: The patients with higher MIA score showed worse outcome of fatal/non-fatal acute coronary syndrome (ACS) (p < 0.001) and composite outcomes of ACS and all-cause mortality (p < 0.001) than with the lower MIA score.In multivariate analysis, ACS showed significantly higher incidence in the MIA score 8-10 group than in the MIA score 0 group (Hazard ratio 6.12 95 % Confidence interval 1.84-20.32 p = 0.003).The presence of MIA factors before KT is an independent predictor of post-transplant CV outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea. dennyjinho@gmail.com.

ABSTRACT

Background: Malnutrition, inflammation, and atherosclerosis (MIA) syndrome is associated with a high mortality rate in patients with end-stage renal disease. However, the clinical relevance of MIA syndrome in kidney transplantation (KT) recipients remains unknown.

Methods: We enrolled 1348 adult KT recipients. Recipients were assessed based on serum albumin, cholesterol, or body mass index for the malnutrition factor and C-reactive protein level for the inflammation factor. Any history of cardiovascular (CV), cerebrovascular, or peripheral vascular disease satisfied the atherosclerosis factor. Each MIA factors were assessed by univariate analysis and we calculated an overall risk score by summing up scores for each independent variable. The enrolled patients were divided into 4 groups depending on the MIA score (0, 2-4, 6, 8-10).

Results: The patients with higher MIA score showed worse outcome of fatal/non-fatal acute coronary syndrome (ACS) (p < 0.001) and composite outcomes of ACS and all-cause mortality (p < 0.001) than with the lower MIA score. In multivariate analysis, ACS showed significantly higher incidence in the MIA score 8-10 group than in the MIA score 0 group (Hazard ratio 6.12 95 % Confidence interval 1.84-20.32 p = 0.003).

Conclusions: The presence of MIA factors before KT is an independent predictor of post-transplant CV outcomes.

No MeSH data available.


Related in: MedlinePlus