Malnutrition, inflamation and atherosclerosis (MIA syndrome) in patients with end stage renal disease on maintenance hemodialysis (a single centre experience)

Allawi, Ali A.

doi:10.1016/j.dsx.2017.09.003

Cited by 31 publications

(22 citation statements)

References 90 publications

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“…Inflammation is also accompanied by malnutrition and hypoalbuminemia. In the study of Allawi et al, carotid atherosclerosis was shown to have a significant association with inflammation (high serum CRP) and malnutrition (low serum albumin) in patients under hemodialysis treatment (25). In our study, ADMA, known to be associated with ED and atherosclerosis, is associated with MIA markers (low albumin, high CRP, high CIMT).…”

Section: Discussionsupporting

confidence: 62%

Serum ADMA, endothelial dysfunction, and atherosclerosis in hypervolemic hemodialysis patients

Doğan¹,

Eser²,

Özkurt³

et al. 2018

Turk J Med Sci

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Background/aim: Asymmetric dimethyl arginine (ADMA) is a strong predictor of cardiovascular disease and mortality in patients under hemodialysis treatment. We aimed to investigate the relationship among volume status, endothelial dysfunction, and ADMA in hemodialysis patients. Materials and methods: A total of 120 patients with a history of hemodialysis treatment were included. ADMA and CRP were measured. Echocardiographic evaluation and carotid artery intima-media thickness (CIMT) measurements were performed. Patients were divided into two groups according to clinical evaluation, ultrafiltration rate, vena cava inferior diameter (VCI), and cardiothoracic index (CTI); the two groups were hypervolemic and normovolemic. Results: The hypervolemic group included 61 patients while the normovolemic group included 59 patients. CIMT was higher in the hypervolemic group, but this result was not statistically significant (0.95 mm versus 0.85 mm, P = 0.232). There was a statistically significant difference between the hypervolemic and normovolemic groups in terms of ADMA (P < 0.001) (0.69 ± 0.57 µmol/L and 0.41 ± 0.04 µmol/L, respectively). Positive correlations were observed between serum ADMA, VCI, CTI, CRP, CIMT, and cardiac mass (P

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Section: Discussionsupporting

confidence: 62%

Serum ADMA, endothelial dysfunction, and atherosclerosis in hypervolemic hemodialysis patients

Doğan¹,

Eser²,

Özkurt³

et al. 2018

Turk J Med Sci

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“…The recommended target of albumin in patients undergoing haemodialysis is 40 g/l. 25 However, an inappropriate diet may result in hyperphosphataemia, another troublesome complication. Although KDOQI guidance suggests that protein intake in patients undergoing maintenance haemodialysis should be 1.2 g/kg per day, research has demonstrated that a low protein intake (0.8 g/kg per day), low phosphorus intake (500 mg/day) and compound a-keto acid therapy effectively reduces serum phosphorus levels in patients undergoing maintenance haemodialysis while the nutritional status remained stable.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, associated factors and cardiocerebral vascular prognosis of anaemia among patients on chronic haemodialysis in South Guangdong, China

Liang

Yong

et al. 2020

J Int Med Res

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Objective To assess the prevalence, associated factors and cardiocerebral vascular prognosis of anaemia in patients undergoing haemodialysis. Methods This multicentre, retrospective, observational cohort study included patients on maintenance haemodialysis in South Guangdong, China. Anaemia in haemodialysis was defined as haemoglobin (Hb) <90 g/l. A proportion of patients were enrolled in a follow-up of the cardiocerebral vascular prognosis. Results A total of 1161 patients were enrolled and 938 were followed-up for cardiocerebral vascular events. Of 1161 patients, 250 (21.5%) had anaemia and 524 (45.1%) had an Hb level of 100–120 g/l. Adjusted multivariate logistic regression analysis demonstrated that frequency of dialysis ≤ twice weekly, hypoalbuminaemia and use of unfractionated heparin were independent factors associated with anaemia. Kaplan–Meier survival curve analysis for no myocardial infarction was 100%, 100%, 100% and 100% after 3, 6, 9 and 12 months, respectively, in patients with Hb < 90 g/l; compared with 97%, 95%, 93% and 93%, respectively, in patients with Hb ≥ 130 g/l. Adjusted Cox proportional hazards regression demonstrated that Hb ≥ 130 g/l was an independent risk factor for myocardial infarction. Conclusion Anaemia is highly prevalent among patients undergoing haemodialysis in South Guangdong and requires careful management.

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“…Inflammation, malnutrition, and the MIA syndrome were common in the maintenance HD patients. [18][19][20] Inflammation and malnutrition are frequently associated with each other, and we often do not know which factors are the causes and which are the consequences. In patients undergoing HD treatment, chronic inflammation and malnutrition are crucial factors for immunity disturbance.…”

Section: Discussionmentioning

confidence: 99%

“…Tables and show a close association between inflammation (showing high serum TNF‐α and hs‐CRP concentrations) and hypoalbuminemia, anemia, chronic complications of long HD treatment such as carpal tunnel syndrome and shoulder pain, and increased serum β2‐M concentrations. Inflammation, malnutrition, and the MIA syndrome were common in the maintenance HD patients . Inflammation and malnutrition are frequently associated with each other, and we often do not know which factors are the causes and which are the consequences.…”

Section: Discussionmentioning

confidence: 99%

Predicting 3‐year mortality based on the tumor necrosis factor alpha concentration in low‐flux hemodialysis patients

Viet

Loc²,

Dung

et al. 2020

Ther Apher Dial

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Tumor necrosis factor alpha (TNF‐α) is an inflammatory cytokine produced during acute inflammation. Few studies have evaluated the association between serum TNF‐α and its receptors and their clinical outcomes in hemodialysis patients. However, a study assessing patients using a low‐flux dialyzer reuse has not been conducted yet. The serum TNF‐α concentrations of 319 prevalent hemodialysis patients (mean age, 45 ± 15 years; median duration of hemodialysis, 48 [interquartile range, 26‐79] months; 185 males and 134 females) was examined to predict their 3‐year mortality. The patients were divided into tertiles according to their serum TNF‐α concentrations: T1 (n = 106; serum TNF‐α concentration, <41.22 pg/mL), T2 (n = 106; serum TNF‐α level, from 41.22 to 67.28 pg/mL), and T3 (n = 107; serum TNF‐α concentration, ≥ 67.29 pg/mL). During the 36‐month follow‐up period, a total of 50 (15.7%) patients died from all causes. The Kaplan‐Meier analysis revealed that the all‐cause mortality in T3 was significantly higher compared to that in T1 and T2 (log‐rank test, P < .001). The serum TNF‐α level was a significant predictor for all‐cause mortality (area under the curve = 0.887, P < .001, cutoff value, 89.812 pg/mL, sensitivity = 76%, specificity = 96.3%). The serum TNF‐α level was a better predictor of mortality than the duration of hemodialysis and serum albumin, serum high‐sensitivity C‐reactive protein, and serum beta‐2 microglobulin concentrations. The serum TNF‐α concentration was a good predictor of the 3‐year mortality in low‐flux hemodialysis patients.

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Malnutrition, inflamation and atherosclerosis (MIA syndrome) in patients with end stage renal disease on maintenance hemodialysis (a single centre experience)

Cited by 31 publications

References 90 publications

Serum ADMA, endothelial dysfunction, and atherosclerosis in hypervolemic hemodialysis patients

Serum ADMA, endothelial dysfunction, and atherosclerosis in hypervolemic hemodialysis patients

Prevalence, associated factors and cardiocerebral vascular prognosis of anaemia among patients on chronic haemodialysis in South Guangdong, China

Predicting 3‐year mortality based on the tumor necrosis factor alpha concentration in low‐flux hemodialysis patients

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