Malnutrition-inflammation-atherosclerosis (MIA) syndrome components in hemodialysis and peritoneal dialysis patients.
BACKGROUND
Malnutrition, inflammation, and atherosclerosis (MIA syndrome) are common in end-stage renal disease (ESRD) patients. Each component of MIA syndrome is the predictor of outcomes in ESRD patients. In this cross-sectional study, we aimed to compare both dialysis modalities for MIA syndrome components.


METHODS
Thirty hemodialysis (HD) (mean age 44 +/- 11 years, 14 male and 16 female, mean time on dialysis: 31.0 +/- 19.0 months) and 30 continuous ambulatory peritoneal dialysis (CAPD) patients (41 +/- 9 years, 12 male and 18 female, mean time on dialysis: 25.5 +/- 21.5 months) were included. In order to determine malnutrition in ESRD patients, serum albumin level and anthropometric measurements were used. For inflammation, serum C-reactive protein level, erythrocyte sedimentation rate, and fibrinogen levels were measured. Mean-carotid artery intima media thickness (m-CIMT), presence of carotid plaque and serum homocysteine level were used to determine atherosclerosis.


RESULTS
Five CAPD patients (16%) and one HD patient (3%) was hypoalbuminemic. HD and CAPD groups were similar for inflammation. Mean-CIMT and serum homocysteine level were higher in HD patients than CAPD patients. There was a positive correlation between homocysteine and m-CIMT.


CONCLUSIONS
Before choosing renal replacement therapy, malnutrition, inflammation, and atherosclerosis parameters must be investigated in ESRD patients. Hemodialysis seems to be more advantageous for malnutrition components than CAPD. Both dialysis modalities seem to be similar for inflammation, and CAPD modality has superiority for atherosclerosis. Before choosing the type of renal replacement therapy, assessment of MIA syndrome components could be useful for individualization of the decision on which dialytic modality is appropriate in ESRD patients.
Tonbul
H Zeki
HZ
Selcuk University, Meram School of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey.
Demir
Murat
M
Altintepe
Lütfullah
L
Güney
Ibrahim
I
Yeter
Ekrem
E
Türk
Süleyman
S
Yeksan
Mehdi
M
Yildiz
Alaattin
A
D000328:Adult; D050197:Atherosclerosis / Q000401:mortality / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000401:mortality / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000401:mortality / Q000628:therapy; D008297:Male; D044342:Malnutrition / Q000401:mortality / Q000628:therapy; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D018709:Statistics, Nonparametric; D013577:Syndrome; D016896:Treatment Outcome
D015415:Biomarkers; D006710:Homocysteine; D002097:C-Reactive Protein