Impact of pretransplantation malnutrition risk on the clinical outcome and graft survival of kidney transplant patients
ABSTRACT Background: The prevalence of malnourished patients before transplantation and the influence of malnutrition on graft and patient outcomes remain underestimated, despite being associated with higher postoperative morbidity and mortality. This study aimed to develop an easy nutritional scre...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Nefrologia
2023-07-01
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| Series: | Brazilian Journal of Nephrology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002023005022501&lng=en&tlng=en |
| _version_ | 1797783321320620032 |
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| author | Marina Ribeiro de Oliveira Santos Marcus Faria Lasmar Evaldo Nascimento Raquel Aparecida Fabreti-Oliveira |
| author_facet | Marina Ribeiro de Oliveira Santos Marcus Faria Lasmar Evaldo Nascimento Raquel Aparecida Fabreti-Oliveira |
| author_sort | Marina Ribeiro de Oliveira Santos |
| collection | DOAJ |
| description | ABSTRACT Background: The prevalence of malnourished patients before transplantation and the influence of malnutrition on graft and patient outcomes remain underestimated, despite being associated with higher postoperative morbidity and mortality. This study aimed to develop an easy nutritional screening tool and evaluate the impact of nutritional status on clinical outcome, graft survival (GS) and mortality risk in kidney transplant patients (KTP). Methods: In this retrospective cohort study including 451 KTP, we developed a score by using anthropometric, clinical, and laboratory measures performed in the pretransplant evaluation. The patients were stratified into 3 groups according to the final score: G1 (0 or 1 point)=low risk, G2 (2 to 4 points)=moderate risk, and G3 (>5 points)=high risk of malnutrition. The patients were monitored after transplantation at least 1 to 10 years. Results: Stratifying the 451 patients based on the pretransplant risk score, G1, G2, and G3 were composed of 90, 292, and 69 patients, respectively. Patients from G1 maintained the lowest serum creatinine levels at hospital discharge when compared with others (p = 0.012). The incidence of infection in the patients from G3 was higher than patients from G1 and G2 (p = 0.030). G3 recipients showed worse GS than G1 patients (p = 0.044). G3 patients showed almost threefold higher risk for graft loss (HR 2.94, 95% CI 1.084-7.996). Conclusions: KTP with higher malnutrition risk score were associated with worse outcomes and GS. The nutritional screening tool is easy to be used in clinical practice to evaluate the patient in preparation for kidney transplant. |
| first_indexed | 2024-03-13T00:24:23Z |
| format | Article |
| id | doaj.art-a2af7fa3a5fc4243b2a453dfea1b376e |
| institution | Directory Open Access Journal |
| issn | 2175-8239 |
| language | English |
| last_indexed | 2024-03-13T00:24:23Z |
| publishDate | 2023-07-01 |
| publisher | Sociedade Brasileira de Nefrologia |
| record_format | Article |
| series | Brazilian Journal of Nephrology |
| spelling | doaj.art-a2af7fa3a5fc4243b2a453dfea1b376e2023-07-11T07:45:20ZengSociedade Brasileira de NefrologiaBrazilian Journal of Nephrology2175-82392023-07-0110.1590/2175-8239-jbn-2022-0150enImpact of pretransplantation malnutrition risk on the clinical outcome and graft survival of kidney transplant patientsMarina Ribeiro de Oliveira Santoshttps://orcid.org/0000-0002-9959-3891Marcus Faria Lasmarhttps://orcid.org/0000-0001-7912-5268Evaldo Nascimentohttps://orcid.org/0000-0002-7008-4022Raquel Aparecida Fabreti-Oliveirahttps://orcid.org/0000-0001-9128-0666ABSTRACT Background: The prevalence of malnourished patients before transplantation and the influence of malnutrition on graft and patient outcomes remain underestimated, despite being associated with higher postoperative morbidity and mortality. This study aimed to develop an easy nutritional screening tool and evaluate the impact of nutritional status on clinical outcome, graft survival (GS) and mortality risk in kidney transplant patients (KTP). Methods: In this retrospective cohort study including 451 KTP, we developed a score by using anthropometric, clinical, and laboratory measures performed in the pretransplant evaluation. The patients were stratified into 3 groups according to the final score: G1 (0 or 1 point)=low risk, G2 (2 to 4 points)=moderate risk, and G3 (>5 points)=high risk of malnutrition. The patients were monitored after transplantation at least 1 to 10 years. Results: Stratifying the 451 patients based on the pretransplant risk score, G1, G2, and G3 were composed of 90, 292, and 69 patients, respectively. Patients from G1 maintained the lowest serum creatinine levels at hospital discharge when compared with others (p = 0.012). The incidence of infection in the patients from G3 was higher than patients from G1 and G2 (p = 0.030). G3 recipients showed worse GS than G1 patients (p = 0.044). G3 patients showed almost threefold higher risk for graft loss (HR 2.94, 95% CI 1.084-7.996). Conclusions: KTP with higher malnutrition risk score were associated with worse outcomes and GS. The nutritional screening tool is easy to be used in clinical practice to evaluate the patient in preparation for kidney transplant.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002023005022501&lng=en&tlng=enKidney TransplantationMalnutritionNutrition AssessmentRenal DialysisRenal Insufficiency, Chronic |
| spellingShingle | Marina Ribeiro de Oliveira Santos Marcus Faria Lasmar Evaldo Nascimento Raquel Aparecida Fabreti-Oliveira Impact of pretransplantation malnutrition risk on the clinical outcome and graft survival of kidney transplant patients Brazilian Journal of Nephrology Kidney Transplantation Malnutrition Nutrition Assessment Renal Dialysis Renal Insufficiency, Chronic |
| title | Impact of pretransplantation malnutrition risk on the clinical outcome and graft survival of kidney transplant patients |
| title_full | Impact of pretransplantation malnutrition risk on the clinical outcome and graft survival of kidney transplant patients |
| title_fullStr | Impact of pretransplantation malnutrition risk on the clinical outcome and graft survival of kidney transplant patients |
| title_full_unstemmed | Impact of pretransplantation malnutrition risk on the clinical outcome and graft survival of kidney transplant patients |
| title_short | Impact of pretransplantation malnutrition risk on the clinical outcome and graft survival of kidney transplant patients |
| title_sort | impact of pretransplantation malnutrition risk on the clinical outcome and graft survival of kidney transplant patients |
| topic | Kidney Transplantation Malnutrition Nutrition Assessment Renal Dialysis Renal Insufficiency, Chronic |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002023005022501&lng=en&tlng=en |
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