American Journal of Kidney Diseases
Volume 56, Issue 1 , Pages 102-111 , July 2010

Evaluation of the Malnutrition-Inflammation Score in Kidney Transplant Recipients

  • Miklos Zsolt Molnar, MD, PhD

      Affiliations

    • Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
    • Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
    • Corresponding Author InformationAddress correspondence to Miklos Zsolt Molnar, MD, PhD, Department of Transplantation and Surgery, Semmelweis University, Baross utca 23; H-1082; Budapest, Hungary
    • ,
  • Andras Keszei, MD, PhD

      Affiliations

    • Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
    • Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
    • ,
  • Maria Eszter Czira, MD

      Affiliations

    • Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
    • ,
  • Anna Rudas

      Affiliations

    • Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
    • ,
  • Akos Ujszaszi

      Affiliations

    • Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
    • ,
  • Bela Haromszeki

      Affiliations

    • Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
    • ,
  • Janos Pal Kosa

      Affiliations

    • First Department of Internal Medicine, Szent Imre Hospital, Budapest, Hungary
    • ,
  • Peter Lakatos, MD, PhD, DSc

      Affiliations

    • First Department of Internal Medicine, Szent Imre Hospital, Budapest, Hungary
    • ,
  • Eniko Sarvary, PhD

      Affiliations

    • Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
    • ,
  • Gabriella Beko, MD

      Affiliations

    • Central Laboratory, Szent Imre Hospital, Budapest, Hungary
    • ,
  • Katalin Fornadi, MD

      Affiliations

    • Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
    • Department of Neurology, Semmelweis University, Szent Imre Hospital, Budapest, Hungary
    • ,
  • Istvan Kiss, MD, PhD

      Affiliations

    • Department of Nephrology, Szent Imre Hospital, Budapest, Hungary
    • ,
  • Adam Remport, MD

      Affiliations

    • Department of Nephrology, Szent Imre Hospital, Budapest, Hungary
    • ,
  • Marta Novak, MD, PhD

      Affiliations

    • Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
    • Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada
    • ,
  • Kamyar Kalantar-Zadeh, MD, MPH, PhD

      Affiliations

    • Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
    • David Geffen School of Medicine at UCLA, UCLA School of Public Health, Los Angeles, CA
    • Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA
    • ,
  • Csaba P. Kovesdy, MD

      Affiliations

    • Division of Nephrology, Salem VA Medical Center, Salem, VA
    • Division of Nephrology, University of Virginia, Charlottesville, VA
    • ,
  • Istvan Mucsi, MD, PhD

      Affiliations

    • Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
    • First Department of Internal Medicine, Szent Imre Hospital, Budapest, Hungary

Received 3 October 2009 ,Accepted 25 February 2010.

References 

  1. Kaizu Y, Ohkawa S, Odamaki M, et al. Association between inflammatory mediators and muscle mass in long-term hemodialysis patients. Am J Kidney Dis. 2003;42(2):295–302
  2. Kalantar-Zadeh K, Ikizler TA, Block G, Avram MM, Kopple JD. Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences. Am J Kidney Dis. 2003;42(5):864–881
  3. Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH. A Malnutrition-Inflammation Score is correlated with morbidity and mortality in maintenance hemodialysis patients. Am J Kidney Dis. 2001;38(6):1251–1263
  4. Maruyama Y, Nordfors L, Stenvinkel P, et al. Interleukin-1 gene cluster polymorphisms are associated with nutritional status and inflammation in patients with end-stage renal disease. Blood Purif. 2005;23(5):384–393
  5. Balakrishnan VS, Guo D, Rao M, et al. Cytokine gene polymorphisms in hemodialysis patients: association with comorbidity, functionality, and serum albumin. Kidney Int. 2004;65(4):1449–1460
  6. Raj DS, Dominic EA, Pai A, et al. Skeletal muscle, cytokines, and oxidative stress in end-stage renal disease. Kidney Int. 2005;68(5):2338–2344
  7. Caglar K, Peng Y, Pupim LB, et al. Inflammatory signals associated with hemodialysis. Kidney Int. 2002;62(4):1408–1416
  8. Fujino Y, Ishimura E, Okuno S, et al. C-Reactive protein is a significant predictor of decrease in fat mass in hemodialysis patients. Biomed Pharmacother. 2005;59(5):264–268
  9. Rahmouni K, Haynes WG, Morgan DA, Mark AL. Role of melanocortin-4 receptors in mediating renal sympathoactivation to leptin and insulin. J Neurosci. 2003;23(14):5998–6004
  10. Rahmouni K, Haynes WG. Leptin signaling pathways in the central nervous system: interactions between neuropeptide Y and melanocortins. Bioessays. 2001;23(12):1095–1099
  11. Ramos EJ, Meguid MM, Campos AC, Coelho JC. Neuropeptide Y, alpha-melanocyte-stimulating hormone, and monoamines in food intake regulation. Nutrition. 2005;21(2):269–279
  12. Carriere I, Dupuy AM, Lacroux A, Cristol JP, Delcourt C. Biomarkers of inflammation and malnutrition associated with early death in healthy elderly people. J Am Geriatr Soc. 2008;56(5):840–846
  13. Karadag F, Kirdar S, Karul AB, Ceylan E. The value of C-reactive protein as a marker of systemic inflammation in stable chronic obstructive pulmonary disease. Eur J Intern Med. 2008;19(2):104–108
  14. Nakamura K, Moriyama Y, Kariyazono H, et al. Influence of preoperative nutritional state on inflammatory response after surgery. Nutrition. 1999;15(11-12):834–841
  15. Stenvinkel P, Heimburger O, Paultre F, et al. Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure. Kidney Int. 1999;55(5):1899–1911
  16. Prakash J, Raja R, Mishra RN, et al. High prevalence of malnutrition and inflammation in undialyzed patients with chronic renal failure in developing countries: a single center experience from eastern India. Ren Fail. 2007;29(7):811–816
  17. Bross R, Zitterkoph J, Pithia J, et al. Association of serum total iron-binding capacity and its changes over time with nutritional and clinical outcomes in hemodialysis patients. Am J Nephrol. 2009;29(6):571–581
  18. Rambod M, Bross R, Zitterkoph J, et al. Association of Malnutrition-Inflammation Score with quality of life and mortality in hemodialysis patients: a 5-year prospective cohort study. Am J Kidney Dis. 2009;53(2):298–309
  19. Kalantar-Zadeh K, Kopple JD. Relative contributions of nutrition and inflammation to clinical outcome in dialysis patients. Am J Kidney Dis. 2001;38(6):1343–1350
  20. Stenvinkel P, Heimburger O, Lindholm B, Kaysen GA, Bergstrom J. Are there two types of malnutrition in chronic renal failure? (Evidence for relationships between malnutrition, inflammation and atherosclerosis (MIA syndrome)). Nephrol Dial Transplant. 2000;15(7):953–960
  21. Wang AY, Woo J, Lam CW, et al. Associations of serum fetuin-A with malnutrition, inflammation, atherosclerosis and valvular calcification syndrome and outcome in peritoneal dialysis patients. Nephrol Dial Transplant. 2005;20(8):1676–1685
  22. Morena M, Delbosc S, Dupuy AM, Canaud B, Cristol JP. Overproduction of reactive oxygen species in end-stage renal disease patients: a potential component of hemodialysis-associated inflammation. Hemodial Int. 2005;9(1):37–46
  23. Kalantar-Zadeh K, McAllister CJ, Lehn RS, Lee GH, Nissenson AR, Kopple JD. Effect of malnutrition-inflammation complex syndrome on EPO hyporesponsiveness in maintenance hemodialysis patients. Am J Kidney Dis. 2003;42(4):761–773
  24. Locatelli F, Andrulli S, Memoli B, et al. Nutritional-inflammation status and resistance to erythropoietin therapy in haemodialysis patients. Nephrol Dial Transplant. 2006;21(4):991–998
  25. Lopes AA, Elder SJ, Ginsberg N, et al. Lack of appetite in haemodialysis patients associations with patient characteristics, indicators of nutritional status and outcomes in the international DOPPS. Nephrol Dial Transplant. 2007;22(12):3538–3546
  26. Molnar MZ, Novak M, Ambrus C, et al. Anemia in kidney transplanted patients. Clin Transplant. 2005;19(6):825–833
  27. Lopez-Gomez JM, Perez-Flores I, Jofre R, et al. Presence of a failed kidney transplant in patients who are on hemodialysis is associated with chronic inflammatory state and erythropoietin resistance. J Am Soc Nephrol. 2004;15(9):2494–2501
  28. Agras PI, Baskin E, Saatci U, et al. Relationship between leptin and bone mineral density in renal transplant recipients. Transplant Proc. 2005;37(7):3106–3108
  29. Bayes B, Granada ML, Pastor MC, et al. Obesity, adiponectin and inflammation as predictors of new-onset diabetes mellitus after kidney transplantation. Am J Transplant. 2007;7(2):416–422
  30. Pachaly MA, do Nascimento MM, Suliman ME, et al. Interleukin-6 is a better predictor of mortality as compared to C-reactive protein, homocysteine, pentosidine and advanced oxidation protein products in hemodialysis patients. Blood Purif. 2008;26(2):204–210
  31. Jassal SV, Schaubel DE, Fenton SS. Baseline comorbidity in kidney transplant recipients: a comparison of comorbidity indices. Am J Kidney Dis. 2005;46(1):136–142
  32. Levey A, Greene T, Kusek J, Beck G, Group MS. A simplified equation to predict glomerular filtration rate from serum creatinine [abstract]. J Am Soc Nephrol. 2000;11(9):155A
  33. Kalantar-Zadeh K, Kleiner M, Dunne E, et al. Total iron-binding capacity-estimated transferrin correlates with the nutritional subjective global assessment in hemodialysis patients. Am J Kidney Dis. 1998;31(2):263–272
  34. Enia G, Sicuso C, Alati G, Zoccali C. Subjective Global Assessment of nutrition in dialysis patients. Nephrol Dial Transplant. 1993;8(10):1094–1098
  35. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–383
  36. Yarlagadda SG, Coca SG, Garg AX. Marked variation in the definition and diagnosis of delayed graft function: a systematic review. Nephrol Dial Transplant. 2008;23(9):2995–3003
  37. Schumacker RE, Lomax RG. A Beginner's Guide to Structural Equation Modeling. 2nd ed.. Mahwah, NJ: Lawrence Erlbaum Associates Inc; 2004;
  38. Kovesdy CP, Kalantar-Zadeh K. Why is protein-energy wasting associated with mortality in chronic kidney disease?. Semin Nephrol. 2009;29(1):3–14
  39. Pou KM, Massaro JM, Hoffmann U, et al. Visceral and subcutaneous adipose tissue volumes are cross-sectionally related to markers of inflammation and oxidative stress: the Framingham Heart Study. Circulation. 2007;116(11):1234–1241
  40. Agarwal R, Davis JL, Smith L. Serum albumin is strongly associated with erythropoietin sensitivity in hemodialysis patients. Clin J Am Soc Nephrol. 2008;3(1):98–104
  41. Kalantar-Zadeh K, Kopple JD, Humphreys MH, Block G. Comparing outcome predictability of markers of malnutrition-inflammation complex syndrome in haemodialysis patients. Nephrol Dial Transplant. 2004;19(6):1507–1519
  42. Karthikeyan V, Karpinski J, Nair RC, Knoll G. The burden of chronic kidney disease in renal transplant recipients. Am J Transplant. 2004;4(2):262–269
  43. Molnar MZ, Czira M, Ambrus C, et al. Anemia is associated with mortality in kidney-transplanted patients—a prospective cohort study. Am J Transplant. 2007;7(4):818–824
  44. Yamada K, Furuya R, Takita T, et al. Simplified nutritional screening tools for patients on maintenance hemodialysis. Am J Clin Nutr. 2008;87(1):106–113
  45. Mak RH, Cheung W, Cone RD, Marks DL. Leptin and inflammation-associated cachexia in chronic kidney disease. Kidney Int. 2006;69(5):794–797
  46. Ayus JC, Achinger SG. At the peril of dialysis patients: ignoring the failed transplant. Semin Dial. 2005;18(3):180–184
  47. Goldstein SL, Ikizler TA, Zappitelli M, Silverstein DM, Ayus JC. Non-infected hemodialysis catheters are associated with increased inflammation compared to arteriovenous fistulas. Kidney Int. 2009;76(10):1063–1069

 Originally published online as doi:10.1053/j.ajkd.2010.02.350 on May 17, 2010.

PII: S0272-6386(10)00681-5

doi: 10.1053/j.ajkd.2010.02.350

American Journal of Kidney Diseases
Volume 56, Issue 1 , Pages 102-111 , July 2010

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