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

BMC Nephrology

Jung Pyo Lee⁴  Young Hoon Kim⁹  Yon Su Kim³  Su-Kil Park¹  Duck-Jong Han⁹  Chun Soo Lim⁴  Yun Kyu Oh⁴  In Mok Jung⁵  Curie Ahn³  Dong Wan Chae^1,10  Jongwon Ha⁷  Jaeseok Yang⁷  Hyosang Kim¹  Clara Tammy Kim⁶  Jung Nam An⁴  Jiwon Ryu²  Jin Ho Hwang⁸ 

[1]Department of Internal Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea

[2]Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea

[3]Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

[4]Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea

[5]Department of Surgery, Seoul National University Boramae Medical Center, Seoul, South Korea

[6]Graduate School of Public Health, Seoul National University, Seoul, South Korea

[7]Transplantation Center, Seoul National University Hospital, Seoul, South Korea

[8]Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea

[9]Department of Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea

[10]Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea

关键词: Malnutrition;    Kidney Transplantation;    Inflammation;    Cardiovascular Outcome;    Atherosclerosis;    Acute Coronary Syndrome;   

Others  :  1220004
DOI  :  10.1186/s12882-015-0108-3

 received in 2015-03-04, accepted in 2015-07-06,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Hwang et al.

【 图 表 】

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