Institute of Pathophysiology, Semmelweis University, Nagyvarad ter 4, 1089 Budapest, Hungary.
Int Urol Nephrol. 2012 Aug;44(4):1257-68. doi: 10.1007/s11255-012-0122-3. Epub 2012 Jan 14.
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 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 cross-sectional survey. Socio-demographic parameters, laboratory results, transplantation-related data, comorbidities, medication and malnutrition-inflammation score (MIS) (Kalantar Score) were tabulated at baseline. Patients completed the Kidney Disease Quality of Life-SF (KDQoL-SF™) self-administered questionnaire.
Mean age was 51 ± 13 years, median (interquartile range, IQR) time since transplantation 66 (83) months, 57% were men, and 19% had diabetes. The median (IQR) MIS was 3 (3). The 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-SF™ and the MIS.
Malnutrition-inflammation score is independently associated with different dimensions of HRQoL in kidney transplant recipients.
慢性肾脏病对患者的健康相关生活质量（HRQoL）有深远影响，具有严重的生理、心理和社会经济影响。终末期肾病患者中蛋白质-能量消耗和炎症的同时发生与更差的 HRQoL 和更高的死亡率相关。我们设计了这项研究，以检查肾移植受者的营养和炎症状态与 HRQoL 之间的关系。
在横断面调查中分析了 100 名随机选择的肾移植患者的数据。在基线时列出了社会人口统计学参数、实验室结果、移植相关数据、合并症、药物和营养不良-炎症评分（MIS）（Kalantar 评分）。患者完成了肾脏病生活质量-SF（KDQoL-SF™）自我管理问卷。
平均年龄为 51 ± 13 岁，中位数（四分位距，IQR）移植后时间为 66（83）个月，57%为男性，19%患有糖尿病。MIS 的中位数（IQR）为 3（3）。MIS 与分析的几乎所有 HRQoL 领域均呈显著负相关，并且在对数转换后的能量/疲劳（β=-0.059，P<0.001）、身体疼痛（β=-0.056，P=0.004）、身体机能（β=-0.029，P=0.022）和症状/问题（β=-0.023，P=0.005）领域的多变量线性回归分析中，这种相关性仍然具有统计学意义，校正年龄、性别、eGFR、透析年限、Charlson 合并症指数和职业状况后。此外，三次样条分析显示，KDQoL-SF™ 的几乎所有领域与 MIS 之间呈线性递增的“剂量反应”关系。
营养不良-炎症评分与肾移植受者的不同 HRQoL 维度独立相关。
