title: Malnutrition-inflammation-atherosclerosis (MIA) syndrome components in hemodialysis and peritoneal dialysis patients.
abstract: 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.
authors.affiliation: Selcuk University, Meram School of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey.
authors.forename: H Zeki
authors.initials: HZ
authors.lastname: Tonbul
authors.forename: Murat
authors.initials: M
authors.lastname: Demir
authors.forename: Lütfullah
authors.initials: L
authors.lastname: Altintepe
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Güney
authors.forename: Ekrem
authors.initials: E
authors.lastname: Yeter
authors.forename: Süleyman
authors.initials: S
authors.lastname: Türk
authors.forename: Mehdi
authors.initials: M
authors.lastname: Yeksan
authors.forename: Alaattin
authors.initials: A
authors.lastname: Yildiz
mesh_terms: 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
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D002097:C-Reactive Protein