Malnutrition–Inflammation–Atherosclerosis (MIA) Syndrome Components in Hemodialysis and Peritoneal Dialysis Patients

Tonbul, Halil Zeki; Demir, Murat; Altıntepe, Lütfullah; Güney, İ̇brahim; Yeter, Ekrem; Türk, Süleyman; Yeksan, Mehdi; Yildiz, Alaattin

doi:10.1080/08860220600583625

Cited by 52 publications

(64 citation statements)

References 40 publications

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“…Other studies found hyperlipidemia more frequently in CAPD patients than in HD patients. 13,14,16 But in our study there was no statistically significant differences between HD and CAPD groups according to lipid and apolipoprotein levels except Lp(a), supporting results reported in the literature. 15,[20][21][22] Correlations between high Lp(a) and ischemic cardiovascular disease, cerebrovascular disease, and peripheral vascular disease have been documented in many reports.…”

Section: Discussionsupporting

confidence: 82%

“…7 Many studies have found CAPD patients to have a more atherogenic lipoprotein profile than do HD patients. [13][14][15] However, studies of the HD population have not identified elevated plasma lipids as the principal risk factor for coronary artery atherosclerosis. 19 In our study, plasma TG, Lp(a), and Apo B levels of patients with ESRD were significantly increased over those in the control group; however, HDL, Apo A-I, albumin, and Apo E levels were decreased.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16][17] Therefore, the aims of this study were to compare patients with HD and patients with CAPD for carotid intima-media thickness (CIMT) and the presence of discrete plaque in the carotid artery and to investigate and compare the effect of dialysis type on lipids and lipoproteins.…”

mentioning

confidence: 99%

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Comparison of atherosclerosis and atherosclerotic risk factors in patients receiving hemodialysis and peritoneal dialysis

Cengiz¹,

Dolu²

2007

Dialysis & Transplantation

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BACKGROUND: Although some studies have found that myocardial infarction and cerebrovascular disease are more common in patients receiving continuous ambulatory peritoneal dialysis (CAPD) than in patients receiving hemodialysis (HD), the results of other studies have not supported these findings. Studies comparing patients receiving HD with patients receiving CAPD have had conflicting results.OBJECTIVE: The aims of this study were to compare the atherosclerotic changes in CAPD and HD patients and to assess which factors might be responsible for atherosclerosis in dialysis patients.METHODS: Enrolled in the study were 33 patients receiving HD, 32 patients receiving CAPD, and 33 controls for a total of 98 participants. Serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein, lipoprotein (a) (Lp[a]), apolipoprotein A-I, apolipoprotein B (Apo B), apolipoprotein E (Apo E), albumin, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, intact parathyroid hormone (iPTH), and ferritin levels were obtained from all patients. Carotid intima-media thickness (CIMT) and plaque number were calculated using B-mode ultrasonography.RESULTS: Serum TG, Lp(a), Apo B, hs-CRP, fibrinogen, ferritin, and iPTH levels were significantly higher in the dialysis groups than in the control group; whereas HDL, Apo E, and albumin levels were decreased (p Ͻ .05); the others were same in the all groups. However, there was no difference between the HD and CAPD groups in the other lipid parameters except Lp(a) (p Ͻ .05). CIMT and plaque number of the patients treated with dialysis were higher than those of the control group (p Ͻ .01), but were not significantly different between the 2 dialysis groups (p Ͼ .05). CIMT and plaque number were positively correlated with age (r ϭ 0.43; p Ͻ .05) and hs-CRP level (r ϭ 0.40; p Ͻ .05) and negative correlated with serum albumin and hs-CRP levels (r ϭ Ϫ0.37, p Ͻ .05; and r ϭ Ϫ0.25; p Ͻ .05, respectively).CONCLUSIONS: Serum Apo B and Lp(a) levels were higher in the CAPD patients than in the HD patients. CIMT and plaque number were positively correlated with age and hs-CRP level and negatively correlated with serum albumin and hs-CRP levels.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Comparison of atherosclerosis and atherosclerotic risk factors in patients receiving hemodialysis and peritoneal dialysis

Cengiz¹,

Dolu²

2007

Dialysis & Transplantation

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“…Malnutrition, inflammation, atheroscleosis/calcification (MIAC) syndrome has been defined as the interaction between increased levels of proinflammatory cytokines, malnutrition, and atherosclerosis/calcification in ESRD patients (5,6). The presence of MIA components was found to be associated with increased mortality and morbidity in ESRD patients receiving PD (7) or HD (8). The coronary artery calcification score (CACS) in patients with ESRD reflects the severity of atherosclerotic vascular disease and predicts cardiovascular events (9,10).…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Epicardial Adipose Tissue and Malnutrition, Inflammation, Atherosclerosis/Calcification Syndrome in ESRD Patients

Türkmen

Kayıkçıoğlu²,

Özbek³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Malnutrition, inflammation, atherosclerosis/calcification (MIAC) and endothelial dysfunction are the most commonly encountered risk factors in the pathogenesis of cardiovascular disease in ESRD patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between CAD and EAT was shown in patients with high risk of coronary artery disease. In this study, we aimed to investigate the relationship between EAT and MIAC syndrome in ESRD patients.Design, setting, participants, & measurements Eighty ESRD patients and 27 healthy subjects enrolled in this cross-sectional study. EAT and coronary artery calcification score were measured by a multidetector computed tomography (MDCT) scanner. Patients with serum albumin Ͻ3.5 mg/dl were defined as patients with malnutrition; those with serum C-reactive protein level Ͼ10 ng/dl (normal range, 0 -5 ng/dl) had inflammation; and those with CACS Ͼ10 had atheroscleosis/calcification.Results Total CACS and EAT measurements were significantly higher in ESRD patients when compared with healthy subjects. There was a statistically significant relationship between EAT and CACS in ESRD patients (r ϭ 0.48). EAT measurements were higher in PD patients than HD patients. Twenty-four of the patients had no component, 31 had one component, 17 had two components, and nine had all of the MIAC components. EAT was found to be significantly increased when the presence of MIAC components increased. EAT was positively correlated with age, body mass index, and presence of MIAC. These parameters were also found as independent predictors of increased EAT.Conclusions We found a relationship between EAT and components of MIAC syndrome in ESRD patients.

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“…Malnütrisyon göstergeleri HD alan grupta daha iyi seyrederken, PD nin ateroskleroz gelişimini önlemede daha etkin olduğu görülmüştür. Bu nedenle tedaviye karar vermeden önce MIA sendromunun bileşenlerinin ayrı ayrı değerlendirilmesi ve bireysel karar verilmesi gerekliliği bildirilmiştir (47). Bir başka çalışmada KVH için en önemli risk faktörlerinden biri olan kronik inflamasyon aterosklerozis gelişimini hızlandırmaktadır (31,32).…”

Section: Mıa Sendromunun Tedavisinde Yeni Stratejilerunclassified

The Malnutrition-Inflammation-Atherosclerosis (MIA) Syndrom

Küçükkatırcı¹,

Şanlıer²

2016

Turk Neph Dial Transpl

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ÖzSon dönem böbrek yetmezliği (SDBY) olan hastalarda malnütrisyon, inflamasyon ve ateroskleroz gelişimi oldukça fazla görülmekte ve her bir parametre kendi başına mortalite ve morbidite oranını artırmaktadır. İlk olarak 2000 yılında ortaya atılan malnütrisyon-inflamasyon-ateroskleroz (MIA) sendromunun temelini, SDBY hastalarında serum proinflamatuvar sitokin düzeylerindeki artış ve bu hastalarda sıklıkla görülen malnütrisyon ve ateroskleroz arasındaki ilişki oluşturmaktadır. SDBY hastalarında proinflamatuvar sitokin seviyelerinin artmasıyla anoreksiyanın da arttığı ve bu durumun malnütrisyona zemin hazırladığı bilinmektedir. Aynı zamanda sitokin seviyelerindeki artışa bağlı olarak ortaya çıkan kronik inflamasyon hızlanmış ateroskleroza neden olabilmektedir. MIA sendromunun bileşenlerinin görülme oranının artmasıyla hastaların yaşam süreleri ve kaliteleri azalmaktadır. Bu nedenle derlemede; MIA sendromunun bileşenleri, bileşenlerin birbiriyle etkileşimi ve her bir bileşenle etkin mücadele etmek için izlenecek yollar hakkında bilgi vermek amaçlanmıştır.anahtar sözcükler: Böbrek yetmezliği, Malnütrisyon, İnflamasyon, Ateroskleroz, Beslenme durumu abStRact Development of malnutrition, inflammation and atherosclerosis are commonly seen in end-stage renal disease (ESRD) patients and the rates of mortality and morbidity are increased by each parameter. The basis of the malnutrition-inflammation-atherosclerosis (MIA) syndrome that has been proposed in 2000 for the first time is the relationship between increased serum levels of proinflammatory cytokine, malnutrition and atherosclerosis that are commonly seen in ESRD patients. The increase of proinflammatory cytokine levels in ESRD patients increases the anorexia and this is known to predispose to malnutrition. At the same time, it is reported that chronic inflammation due to elevated cytokine levels causes accelerated atherosclerosis. The life expectancy and quality of life of patients decreases with the increasing incidence of the components of the MIA syndrome. In this review, we aimed to explain the components of the MIA syndrome, the interactions of these components and effective treatment of each component.

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Malnutrition–Inflammation–Atherosclerosis (MIA) Syndrome Components in Hemodialysis and Peritoneal Dialysis Patients

Cited by 52 publications

References 40 publications

Comparison of atherosclerosis and atherosclerotic risk factors in patients receiving hemodialysis and peritoneal dialysis

Comparison of atherosclerosis and atherosclerotic risk factors in patients receiving hemodialysis and peritoneal dialysis

The Relationship between Epicardial Adipose Tissue and Malnutrition, Inflammation, Atherosclerosis/Calcification Syndrome in ESRD Patients

The Malnutrition-Inflammation-Atherosclerosis (MIA) Syndrom

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