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

被引：27

作者：

Hwang, Jin Ho ^{[1
]}

Ryu, Jiwon ^{[2
]}

An, Jung Nam ^{[3
]}

Kim, Clara Tammy ^{[4
]}

Kim, Hyosang ^{[5
,6
]}

Yang, Jaeseok ^{[7
]}

Ha, Jongwon ^{[7
]}

Chae, Dong Wan ^{[8
]}

Ahn, Curie ^{[7
,9
]}

Jung, In Mok ^{[10
]}

Oh, Yun Kyu ^{[3
]}

Lim, Chun Soo

Han, Duck-Jong ^{[11
]}

Park, Su-Kil ^{[5
,6
]}

Kim, Yon Su ^{[9
]}

Kim, Young Hoon ^{[6
,11
]}

Lee, Jung Pyo ^{[3
]}

机构：

[1] Chung Ang Univ Hosp, Dept Internal Med, Seoul, South Korea

[2] Hallym Univ, Dept Internal Med, Coll Med, Chunchon, South Korea

[3] Seoul Natl Univ, Dept Internal Med, Boramae Med Ctr, Seoul, South Korea

[4] Seoul Natl Univ, Grad Sch Publ Hlth, Seoul, South Korea

[5] Asan Med Ctr, Dept Internal Med, Seoul, South Korea

[6] Univ Ulsan, Coll Med, Seoul, South Korea

[7] Seoul Natl Univ Hosp, Transplantat Ctr, Seoul 110744, South Korea

[8] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Songnam, South Korea

[9] Seoul Natl Univ, Coll Med, Dept Internal Med, Seoul 151, South Korea

[10] Seoul Natl Univ, Dept Surg, Boramae Med Ctr, Seoul, South Korea

[11] Asan Med Ctr, Dept Surg, Seoul, South Korea

来源：

BMC NEPHROLOGY | 2015年 / 16卷

关键词：

Acute Coronary Syndrome; Atherosclerosis; Cardiovascular Outcome; Inflammation; Kidney Transplantation; Malnutrition; C-REACTIVE PROTEIN; CHRONIC-RENAL-FAILURE; RISK-FACTORS; GRAFT FUNCTION; DISEASE; MORTALITY; RECIPIENTS; HEART; ASSOCIATION; PREDICTORS;

D O I：

10.1186/s12882-015-0108-3

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

100201 [内科学]; 100221 [泌尿外科学];

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.

引用

页数：12

共 35 条

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