Kidney Week

Abstract: TH-PO135

Association Between Malnutrition – Inflammation Score and Bone Fractures in Prevalent Kidney Transplant Recipients

Session Information

• Transplantation: Cardiovascular and Metabolic Diseases
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Miklos Zsolt Molnar,

• Gaipov, Abduzhappar, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Abduzhappar Gaipov,

• Cseprekál, Orsolya, Semmelweis University, Budapest, Hungary

Orsolya Cseprekál,

• Potukuchi, Praveen Kumar, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Praveen Kumar Potukuchi,

• Kabulbayev, Kairat, Kazakh national medical university, Almaty, Kazakhstan

Kairat Kabulbayev,

• Talwar, Manish, UTHSC, Germantown, Tennessee, United States

Manish Talwar,

• Eason, James D., University of TN/Methodist Transplant Institute, Memphis, Tennessee, United States

James D. Eason,

• Mucsi, Istvan, University of Toronto , Toronto, Ontario, Canada

Istvan Mucsi,

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

Background

Kidney transplant recipients (KTR) have a 4-fold higher risk of fracture compared to the general population. Chronic inflammation and protein energy wasting (PEW) syndrome are common in KTR and associated with poor outcomes. The presence of inflammation and PEW syndrome can directly affect bone resorption and bone formation, leading to bone loss and fractures. We assessed the association between Malnutrition-Inflammation Score (MIS) a marker of PEW and bone fractures in KTR.

Methods

This prospective cohort study included 839 prevalent KTR. MIS is a semiquantitative instrument for the evaluation of Malnutrition–Inflammation Complex Syndrome, was calculated at the study entry. Self-reported history of fractures was recorded during the 2-year follow-up period. The association between MIS and bone fractures was examined in logistic regression analyses with adjustment for age, gender, eGFR, smoking habits, history of pre-transplant bone fractures and acute rejection.

Results

Mean age was 51±13 years and 56% of patients were males. Fifty-five (7%) patients experienced bone fractures during the follow-up period. In logistic regressions, MIS score showed linear association with increased risk of fracture (Figure 1). Each 1-point higher MIS was associated with 23% higher risk of bone fractures (odds ratio (OR) and 95%CI: 1.23, 1.12–1.34), which remained significant after multivariable adjustments (OR: 1.17, 95%CI: 1.06–1.29).

Conclusion

The MIS is independently associated with new bone fractures in prevalent KTR.

Figure 1. An association of MIS with bone fractures using cubic splines