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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

Kaplan-Meier curves of ACS, composite outcomes of ACS, graft outcome, and death in patients in MIA score groups. a-b. The patients with higher MIA score showed worse outcome of ACS (p < 0.001) and composite outcomes of ACS and death (p < 0.001) than those with lower MIA scores. c-d. Graft outcome and all-cause mortality were not different between the groups (p = 0.973 and p = 0.183, respectively)
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Fig3: Kaplan-Meier curves of ACS, composite outcomes of ACS, graft outcome, and death in patients in MIA score groups. a-b. The patients with higher MIA score showed worse outcome of ACS (p < 0.001) and composite outcomes of ACS and death (p < 0.001) than those with lower MIA scores. c-d. Graft outcome and all-cause mortality were not different between the groups (p = 0.973 and p = 0.183, respectively)

Mentions: The patients were divided into 4 groups depending on MIA scores and the ACS, graft outcome, and mortality were evaluated between groups. The ACS occurred in total of 33 patients (2.4 %). The patients with higher MIA scores showed worse ACS outcomes (p < 0.001, Fig. 3a) and composite outcomes of ACS and death (p < 0.001, Fig. 3b) than those in the group with lower MIA scores.Fig. 3


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)

Kaplan-Meier curves of ACS, composite outcomes of ACS, graft outcome, and death in patients in MIA score groups. a-b. The patients with higher MIA score showed worse outcome of ACS (p < 0.001) and composite outcomes of ACS and death (p < 0.001) than those with lower MIA scores. c-d. Graft outcome and all-cause mortality were not different between the groups (p = 0.973 and p = 0.183, respectively)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Kaplan-Meier curves of ACS, composite outcomes of ACS, graft outcome, and death in patients in MIA score groups. a-b. The patients with higher MIA score showed worse outcome of ACS (p < 0.001) and composite outcomes of ACS and death (p < 0.001) than those with lower MIA scores. c-d. Graft outcome and all-cause mortality were not different between the groups (p = 0.973 and p = 0.183, respectively)
Mentions: The patients were divided into 4 groups depending on MIA scores and the ACS, graft outcome, and mortality were evaluated between groups. The ACS occurred in total of 33 patients (2.4 %). The patients with higher MIA scores showed worse ACS outcomes (p < 0.001, Fig. 3a) and composite outcomes of ACS and death (p < 0.001, Fig. 3b) than those in the group with lower MIA scores.Fig. 3

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