Hypertension and nephrology

[Protein-energy wasting and quality of life in kidney transplant recipients]

UJSZÁSZI Ákos1, VÁRADY Tímea1, CZIRA Mária Eszter2, FORNÁDI Katalin2,3, NOVÁK Márta2,4, MUCSI István1,2,5, MOLNÁR Miklós Zsolt1,6

SEPTEMBER 21, 2012

Hypertension and nephrology - 2012;16(03-04)

[Chronic kidney disease has profound effects on the health related quality of life (HRQoL) of patients with serious physiological, psychological and socio-economic implications. The co-occurrence of protein-energy wasting (PEW) and inflammation in end stage renal disease patients is associated with worse HRQoL and increased mortality. We designed this study to examine the relationship between nutritional and inflammatory status and HRQoL in kidney transplant recipients. Data from 100 randomly selected kidney transplant patients were analyzed in a crosssectional survey. Socio-demographic parameters, laboratory results, transplantation related data, co-morbidities, medication and malnutrition-inflammation score (MIS) (Kalantar Score) were tabulated at baseline. Patients completed the Kidney Disease Quality of Life-SF (KDQoL-SFTM) self-administered questionnaire. Mean age was 51±13 years, median (interquartile range, IQR) time since transplantation 66 (83) months, 57% were males and 19% had diabetes. The median (IQR) MIS was 3 (3). MIS significantly and negatively correlated with almost all HRQoL domains analyzed, and this association remained significant in multivariate linear regression analysis for the log-transformed scores on energy/fatigue (β=-0.059, p<0.001), bodily pain (β=-0.056, p=0.004), physical functioning (β=-0.029, p=0.022), and symptoms/problems (β=-0.023, p=0.005) domains after statistical correction for age, gender, eGFR, dialysis vintage, Charlson Comorbidity Index and occupational status. Additionally, cubic spline analyses revealed linearly increasing, “dose-response” relationship between almost all domains of KDQoL-SFTM and the MIS. Malnutrition Inflammation Score is independently associated with different dimensions of health related quality of life in kidney transplant recipients.]

AFFILIATIONS

  1. Semmelweis Egyetem, Kórélettani Intézet, Budapest
  2. Semmelweis Egyetem, Magatartástudományi Intézet, Budapest
  3. Semmelweis Egyetem, Neurológiai Klinika, Budapest
  4. Department of Psychiatry, University Health Network, University of Toronto, Toronto, Kanada
  5. Department of Medicine, Division of Nephrology, McGill University Health Centre, Montreal, Quebec, Kanada
  6. Harold Simmons Center for Chronic Disease Research & Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, Amerikai Egyesült Államok

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