Association between the malnutrition-inflammation score and post-transplant anaemia

Miklos Z. Molnar, Maria E. Czira, Anna Rudas, Akos Ujszaszi, Bela Haromszeki, Janos P. Kosa, Peter Lakatos, Gabriella Beko, Eniko Sarvary, Marina Varga, Katalin Fornadi, Marta Novak, Laszlo Rosivall, Istvan Kiss, Adam Remport, David J. Goldsmith, Csaba P. Kovesdy, Istvan Mucsi

Research output: Contribution to journalArticle

43 Citations (Scopus)


Background. Post-transplant anaemia (PTA) is common and is associated with adverse consequences. The protein-energy wasting (PEW) syndrome is associated with erythropoietin resistance in patients on maintenance dialysis. We assessed the association between PEW and PTA in a large prevalent cohort of stable kidney-transplanted patients.Methods. Data from 942 prevalent kidney-transplanted patients were analysed. Socio-demographic parameters, laboratory results, transplantation-related data and medication were obtained from the charts. Biomarkers reflecting nutritional status and inflammation [serum leptin, albumin, interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and C-reactive protein] were measured. Anthropometric measures and the malnutrition-inflammation score (MIS) were also tabulated. Anaemia was defined according to the guidelines of the American Society of Transplantation.Results. Mean age was 51 ± 13 years, 57% were males and 22% had diabetes. The prevalence of PTA was 33%. The haemoglobin (Hb) level significantly and negatively correlated with the MIS (rho = - 0.316), marginally with serum TNF-α (rho = - 0.079) and serum IL-6 (rho = - 0.075) and positively with serum transferrin (r = 0.298), serum albumin (r = 0.274), abdominal circumference (r = 0.254) and serum leptin (rho = - 0.152), P < 0.05 for all. In a multivariable linear regression model, MIS was independently associated with Hb (beta = - 0.118, P = 0.004) in patients with estimated glomerular filtration rate (eGFR) lower than or equal to 60 mL/min/1.73 m 2, but not in patients with higher eGFR.Conclusions. The MIS is independently associated with PTA in the kidney-transplanted population with eGFR lower than or equal to 60 mL/min/1.73 m2.

Original languageEnglish
Pages (from-to)2000-2006
Number of pages7
JournalNephrology Dialysis Transplantation
Issue number6
Publication statusPublished - Jun 2011


  • inflammation
  • kidney transplantation
  • post-transplant anaemia
  • protein-energy wasting

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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