Clinical value of the malnutrition-inflammation-atherosclerosis syndrome for long-term prediction of cardiovascular mortality in patients with end-stage renal disease: a 5-year prospective study

Nephron Clin Pract. 2008;108(2):c99-c105. doi: 10.1159/000113526. Epub 2008 Jan 22.

Abstract

Background/aim: Mortality resulting from cardiovascular disease in patients with end-stage renal disease (ESRD) is high. In this study we sought to investigate the clinical value of the malnutrition-inflammation-atherosclerosis (MIA) syndrome for long-term prediction of cardiovascular mortality in patients treated with ESRD.

Methods: A total of 42 ESRD patients on hemodialysis were enrolled. Inflammatory markers and nutritional parameters were determined. Carotid atherosclerosis was investigated by ultrasonographically evaluated carotid intima-media thickness (cIMT). Mortality was evaluated at a 5-year follow-up.

Results: No correlation was evident between nutritional markers and inflammatory indexes. cIMT was inversely correlated with predialysis serum albumin. In the overall population of 42 patients, 11 (26.2%) died of cardiovascular causes during follow-up. Kaplan-Meier survival curves indicate that cIMT (> or =0.9 mm), C-reactive protein (CRP) (>1 mg/dl), and serum albumin (<3.5 g/dl) predict cardiovascular death in patients with ESRD.

Conclusions: We have demonstrated that cIMT, CRP and serum albumin predict long-term mortality in ERSD patients. Our study suggests that further investigation of the MIA syndrome will provide insights into the susceptibility to CVD in this patient group.

MeSH terms

  • Adult
  • Aged
  • Anthropometry
  • Atherosclerosis / complications*
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality*
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / pathology
  • Female
  • Humans
  • Inflammation / complications*
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / mortality
  • Male
  • Malnutrition / complications*
  • Middle Aged
  • Prospective Studies
  • Renal Dialysis
  • Risk Factors
  • Serum Albumin / analysis
  • Statistics, Nonparametric
  • Syndrome
  • Ultrasonography

Substances

  • Serum Albumin
  • C-Reactive Protein