Malnutrition, Inflammation, Atherosclerosis Syndrome (MIA) and Diet Recommendations among End-Stage Renal Disease Patients Treated with Maintenance Hemodialysis

Maraj, Małgorzata; Kuśnierz-Cabała, Beata; Dumnicka, Paulina; Gala-Błądzińska, Agnieszka; Gawlik, Katarzyna; Pawlica-Gosiewska, Dorota; Ząbek-Adamska, Anna; Mazur-Laskowska, Małgorzata; Ceranowicz, Piotr; Kuźniewski, Marek

doi:10.3390/nu10010069

Cited by 85 publications

(72 citation statements)

References 31 publications

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“…The finding that TGF- β 1 levels demonstrated a modest significant correlation with hs-CRP and albumin (a marker of malnutrition) was consistent with the report of Stefoni et al [ 40 ]. Furthermore, previous studies had suggested a link between malnutrition, inflammation, and cardiovascular disease morbidity and mortality in end-stage renal disease patients [ 51 – 54 ]. Therefore, the association between serum TGF- β 1 levels and hs-CRP may suggest the degree of vascular inflammation, while correlation with low serum albumin may suggest a state of malnutrition which is very common in CKD patients [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Transforming Growth Factor-β Protects against Inflammation-Related Atherosclerosis in South African CKD Patients

Hassan

Duarte

Dix-Peek

et al. 2018

International Journal of Nephrology

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Background Transforming growth factor-β (TGF-β) may inhibit the development of atherosclerosis. We evaluated serum levels of TGF-β isoforms concurrently with serum levels of endotoxin and various inflammatory markers. In addition, we determined if any association exists between polymorphisms in the TGF-β1 gene and atherosclerosis in South African CKD patients. Methods We studied 120 CKD patients and 40 healthy controls. Serum TGF-β1, TGF-β2, TGF-β3, endotoxin, and inflammatory markers were measured. Functional polymorphisms in the TGF-β1 genes were genotyped using a polymerase chain reaction-sequence specific primer method and carotid intima media thickness (CIMT) was assessed by B-mode ultrasonography. Results TGF-β isoforms levels were significantly lower in the patients with atherosclerosis compared to patients without atherosclerosis (p<0.001). Overall, TGF-β isoforms had inverse relationships with CIMT. TGF-β1 and TGF-β2 levels were significantly lower in patients with carotid plaque compared to those without carotid plaque [TGF-β1: 31.9 (17.2 – 42.2) versus 45.9 (35.4 – 58.1) ng/ml, p=0.016; and TGF-β2: 1.46 (1.30 – 1.57) versus 1.70 (1.50 – 1.87) ng/ml, p=0.013]. In multiple logistic regression, age, TGF-β2, and TGF-β3 were the only independent predictors of subclinical atherosclerosis in CKD patients [age: odds ratio (OR), 1.054; 95% confidence interval (CI): 1.003 – 1.109, p=0.039; TGF-β2: OR, 0.996; 95% CI: 0.994–0.999, p=0.018; TGF-β3: OR, 0.992; 95% CI: 0.985–0.999, p=0.029). TGF-β1 genotypes did not influence serum levels of TGF-β1 and no association was found between the TGF-β1 gene polymorphisms and atherosclerosis risk. Conclusion TGF-β isoforms seem to offer protection against the development of atherosclerosis among South African CKD patients.

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Section: Discussionmentioning

confidence: 99%

Transforming Growth Factor-β Protects against Inflammation-Related Atherosclerosis in South African CKD Patients

Hassan

Duarte

Dix-Peek

et al. 2018

International Journal of Nephrology

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“…are associated with frailty and anaemia, respectively, and markers of inflammation which are involved in the malnutrition-inflammation-atherosclerosis (MIA) syndrome [48][49][50]. Serum protein levels are prognostic factors related to frailty in patients with ESKD [50].…”

Section: Plos Onementioning

confidence: 99%

Markers of protein-energy wasting and physical performance in haemodialysis patients: A cross-sectional study

et al. 2020

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Background Physical impairments are common in uraemia, as reflected by the high risk of falls of haemodialysis (HD) patients. Furthermore, these patients often suffer from malnutrition. Objective Up to now, it is unknown which aspects of physical performance are predominantly driven by malnutrition in HD patients. As this answer could steer different interventions, the aim of this study was to evaluate the cross-sectional relationship between nutritional status, muscle strength, exercise capacity and the risk of falls. Methods This study recruited HD patients between December 2016 and March 2018 from two hospital-based and five satellite dialysis units (registration number on clinicaltrial.gov: NCT03910426). The mini-nutritional assessment scale as well as objective measures of protein-energy wasting were obtained (total iron-binding capacity, total protein levels, and CRP). Physical assessment included muscle strength (quadriceps, handgrip force, and sitto-stand test), exercise capacity (six-minute walking test) and the risk of falls (Tinetti, FIC-SIT, and dialysis fall index). Their interrelationship was analysed by ridge regression models. Results Out of 113 HD patients (mean age 67 years ± 16.1, 57.5% male) 36.3% were malnourished according to the mini-nutritional assessment scale and a majority had impaired quadriceps force (86.7%), six-minute walking test (92%), and an increased risk of falls (73.5%). Total protein and CRP levels were identified as relevant nutritional factors in the association with physical performance. Nutritional parameters explained 9.2% of the variance in the risk of

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“…Systemic chronic inflammation is a frequent and unsolved problem of patients with CKD . This chronic inflammatory process causes malnutrition, inflammation, and atherosclerosis (MIA) syndrome which is associated with increased mortality and decreased quality of life .…”

Section: Discussionmentioning

confidence: 99%

Oral Candida Colonization as a Risk Factor for Chronic Inflammation and Atherosclerosis in Hemodialysis Patients

et al. 2019

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The purpose of this study was to determine the prevalence of oral Candida spp. in HD patients and to investigate its relation with systemic inflammation and atherosclerosis. Microbiological samples were taken from buccal mucosa, palate, and dental prosthesis with a cotton swab. High‐sensitivity CRP (hsCRP) and IL‐6 were measured as inflammation markers. A total of 69 patients (58% male and median age 62 years) were enrolled in this study; 53.6% of total patients had oral Candida colonization. HsCRP and IL‐6 levels were found to be significantly higher in the oral Candida colonization positive group than in the Candida colonization negative group (P = 0.002 and P = 0.01, respectively). HDL levels were significantly lower in the Candida colonization positive group (P = 0.03). Peripheral artery disease (P = 0.05) and oral Candida colonization (P = 0.002) were significantly associated with inflammation. In addition to conventional risk factors such as age (P = 0.03), diabetes (P = 0.001), and peripheral artery disease (P = 0.002), oral Candida colonization is associated with coronary artery disease (P = 0.04). Oral Candida colonization might be associated with chronic inflammation and development of atherosclerosis in HD patients.

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Malnutrition, Inflammation, Atherosclerosis Syndrome (MIA) and Diet Recommendations among End-Stage Renal Disease Patients Treated with Maintenance Hemodialysis

Cited by 85 publications

References 31 publications

Transforming Growth Factor-β Protects against Inflammation-Related Atherosclerosis in South African CKD Patients

Transforming Growth Factor-β Protects against Inflammation-Related Atherosclerosis in South African CKD Patients

Markers of protein-energy wasting and physical performance in haemodialysis patients: A cross-sectional study

Oral Candida Colonization as a Risk Factor for Chronic Inflammation and Atherosclerosis in Hemodialysis Patients

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