Chronic kidney disease (CKD) has profound effects on the quality of life (QoL) of patients with serious mental health, physiological, and socio-economic implications. The co-occurrence of inflammation and protein-energy wasting in patients with CKD (called the Malnutrition-Inflammation Complex Syndrome (MICS)) is known to be associated with adverse medical outcomes and increased mortality. We designed this study to examine the relationship between nutritional and inflammational status and QoL in patients with kidney transplant.

Data from 100 randomly selected patients were analyzed in a cross-sectional survey. Socio-demographic parameters, laboratory results, transplantation related anamnestic data, co-morbidities and medication were tabulated at baseline. MICS was assessed with a recently developed scoring system (Malnutrition Inflammation Score - MIS). Health related quality of life (HRQOL) was assessed with the KDQOL-SFTM questionnaire.

Mean age was 51±13 years, median (Interquartile range, IQR) time since transplantation 65 (83) months, 57% were males 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 or near significant in multivariate linear regression analysis for the log-transformed scores on Energy/fatigue (beta=-0.059 p< 0.001), Bodily pain (beta=-0.056 p=0.004), Physical functioning (beta=-0.029, p=0.072), Emotional well-being (beta=-0.024 p=0.077), Symptoms/problems (beta=-0.023 p=0.005) and Sleep domains (beta=-0.027, p=0.056) after statistical correction for age, gender, renal function, dialysis time, comorbidity and occupational status.

Malnutrition Inflammation Score is independently associated with different dimensions of health related quality of life in kidney transplanted patients.