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

Cited 14 time in Web of Science Cited 12 time in Scopus
Authors
Hwang, Jin Ho; Ryu, Jiwon; An, Jung Nam; Kim, Clara Tammy; Kim, Hyosang; Yang, Jaeseok; Ha, Jongwon; Chae, Dong Wan; Ahn, Curie; Jung, In Mok; Oh, Yun Kyu; Lim, Chun Soo; Han, Duck-Jong; Park, Su-Kil; Kim, Yon Su; Kim, Young Hoon; Lee, Jung Pyo
Issue Date
2015-07-21
Publisher
BioMed Central
Citation
BMC Nephrology, 16(1):109
Keywords
Acute Coronary SyndromeAtherosclerosisCardiovascular OutcomeInflammationKidney TransplantationMalnutrition
Description
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
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.
Language
English
URI
http://hdl.handle.net/10371/100568
DOI
https://doi.org/10.1186/s12882-015-0108-3
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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