Association between the Malnutrition–Inflammation Score and depressive symptoms in kidney transplanted patients

• Published in: General hospital psychiatry Vol. 33; no. 2; pp. 157 - 165
• Main Authors: Czira, Maria E., M.D, Lindner, Anett V., M.D, Szeifert, Lilla, M.D., Ph.D, Molnar, Miklos Z., M.D., Ph.D, Fornadi, Katalin, M.D, Kelemen, Andrea, Laszlo, Gergely, Mucsi, Istvan, M.D., Ph.D, Keszei, Andras P., M.D., Ph.D, Kennedy, Sidney H., M.D, Novak, Marta, M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2011
• Subjects: Adult; Biomarkers - blood; Cross-Sectional Studies; Depression; Depression - physiopathology; Female; Humans; Inflammation; Inflammation - diagnosis; Inflammation - physiopathology; Kidney Failure, Chronic - surgery; Kidney transplant; Kidney Transplantation - psychology; Male; Malnutrition; Malnutrition - physiopathology; Malnutrition–Inflammation Score; Middle Aged; Psychiatry; Regression Analysis; Surveys and Questionnaires; Depression; Inflammation; Kidney transplant; Malnutrition; Malnutrition–Inflammation Score
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2011.01.012

Abstract Objective Depressive symptoms and the Malnutrition–Inflammation Complex Syndrome (MICS) are prevalent in patients with chronic kidney disease. The complex relationship between MICS and depression has never been studied in kidney transplanted (Tx) patients. Here we evaluate the association between the Malnutrition–Inflammation Score (MIS) (Kalantar score) and depressive symptoms in Tx patients. Methods Cross-sectional data of 973 prevalent Tx patients were analyzed. Sociodemographic and anthropometric characteristics and clinical and laboratory data were collected, and serum levels of inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α)] were measured. The Center for Epidemiologic Studies-Depression (CES-D) scale, the MIS and the Charlson Comorbidity Index (CCI) were computed. We used linear regression analysis to examine whether the relationship between MIS and CES-D score is independent from sociodemographic and laboratory parameters. Results The CES-D score, corrected for age, gender and estimated glomerular filtration rate weakly but significantly correlated with serum IL-6 and the CCI (0.124 and 0.103, respectively; P <.05 for both) and marginally significantly with CRP (0.06; P =.06). We found a moderate correlation between CES-D score and MIS (0.262; P <.001). In a multivariable linear regression model, the MIS was independently associated with the CES-D score ( B =0.110; P <.001). Conclusions The MIS was significantly associated with depressive symptoms after adjusting for important covariables in patients after renal transplantation.