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

Jin Ho Hwang, Jiwon Ryu, Jung Nam An, Clara Tammy Kim, Hyosang Kim, Jaeseok Yang, Jongwon Ha, Dong Wan Chae, Curie Ahn, In Mok Jung, Yun Kyu Oh, Chun Soo Lim, Duck Jong Han, Su Kil Park, Yon Su Kim, Young Hoon Kim, Jung Pyo Lee

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


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.

Original languageEnglish
Article number109
JournalBMC nephrology
Issue number1
StatePublished - 21 Jul 2015


  • Acute Coronary Syndrome
  • Atherosclerosis
  • Cardiovascular Outcome
  • Inflammation
  • Kidney Transplantation
  • Malnutrition

Cite this