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

ABSTRACT

Background Protein–energy wasting (PEW) is a commoncondition in patients with chronic kidney disease (CKD)including dialysis and kidney transplant recipients (TX)and frequently assessed with malnutrition–inflammationscore (MIS). We hypothesized that (1) the MIS and PEWparameters are correlated with kidney function and (2) theMIS and PEW parameters are more severe in TX than innon-dialysis (ND) CKD patients with similar eGFR.Methods In this study, we matched 203 ND-CKD and 203TX patients from two independently assembled cohorts ofpatients based on estimated glomerular filtration rate (eGFR)and compared various PEW parameters between the two groups using unadjusted and case-mix adjusted linear regressionand conditional logistic regression analysis models.Results In the combined cohort (n = 406) of patients, themean ± SD age was 57 ± 12 years; included 55 % men and35 % diabetics; and demonstrated a mean ± SD baselineeGFR of 29 ± 11 ml/min/1.73 m2. The eGFR correlated positivelywith serum albumin (ρ = 0.26, p < 0.001) and negatively(ρ = −0.33, p < 0.001) with MIS. ND-CKD and TX patientshad similar MIS, PEW parameters such as waist circumference,serum CRP, albumin, and leptin levels. After case-mixadjustment, TX status was associated with higher waist circumference(standardized coefficient 0.187, p < 0.001), lowerBMI (standardized coefficient −0.204, p < 0.001), and lowerSGA score (standardized coefficient 0.156, p = 0.006).Conclusions We found associations between lower eGFRand various PEW measures in both the ND-CKD and TXpopulations. Additionally, we did not observe significantdifferences in the burden of PEW parameters between theCKD and TX populations.