MALNUTRITION-INFLAMMATION-ATHEROSCLEROSIS (MIA) SYNDROME IN HEMODIALYSIS PATIENTS

2016 ◽  
pp. 99-104
Author(s):  
Thi Khanh Trang Ngo ◽  
Bui Bao Hoang
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
High Risk ◽  
Cardiovascular Events ◽  
Inflammatory Marker ◽  
Hemodialysis Patients ◽  
Dialysis Patients ◽  
Number Of Patients ◽  
The Relationship ◽  
Mia Syndrome

Background: Mortality resulting from cardiovascular disease in patients with end-stage renal disease (ESRD) is high. In this study we study characteristics of the malnutrition, inflammation, atherosclerosis (MIA) syndrome; relationship between MIA syndrome and the cardiovascular events in hemodialysis patients. Subjects and methods: A total of 61 hemodialysis patients were enrolled. Inflammatory marker (hs CRP) and nutritional parameters (albumin, prealbumin, BMI) were determined. Carotid atherosclerosis was investigated by ultrasonographically evaluated carotid intima-media thickness (cIMT). Results: -The characteristics of the malnutrition, inflammation, atherosclerosis(MIA) syndrome in in peritoneal dialysis patients: + MIA2-3 group had an average age lower than MIA0 group + MIA2-3 group had lower albumin levels and BMI than MIA0 group. + The prevalence of malnutrition (50.8%), inflammation (27.9%), and atherosclerosis (52.5%); 24 (39.3%) of the patients had one risk factor; 22 (36.1%) of the patients had two risk factors; 4 (6.6%) of the patients had all three risk factors. No signs of either malnutrition, inflammation or atherosclerosis were seen in 11 (18.0%) of patients. Note that a considerable number of patients with malnutrition (23/31 patients) had signs of inflammation or atherosclerosis or both; 12/32 patients with atherosclerosis had signs of inflammation or malnutrition or both. - The relationship between MIA syndrome and the cardiovascular events in peritoneal dialysis patients: We have found the relationship between component M (malnutrition) and the cardiovascular events in syndrome MIA (HR: 4.23 95% CI: 1.89-9.50). Our study suggests that high risk cardiovascular events in patients with 2 or more elements in MIA syndrome (HR: 2.40 95% CI: 1.16-5.00). Conclusion: We had demonstrated an association between malnutrition, inflammation and atherosclerosis; component M (malnutrition) and the cardiovascular events in hemodialysis patients; high risk cardiovascular events in patients with 2 or more elements in MIA syndrome. Key words: Malnutrition-inflammation-atherosclerosis syndrome, hemodialysis

P1180EVOLUTION OF SERUM B2MICROGLOBULIN LEVELS IN INCIDENT PERITONEAL DIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Diego Barbieri ◽  
ANDRÉS FELIPE DELGADO ◽  
Ana García-Prieto ◽  
Almudena Vega ◽  
Soraya Abad Esttebanez ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Cardiovascular Events ◽  
Prospective Observational Study ◽  
Residual Renal Function ◽  
Hemodialysis Patients ◽  
Uremic Toxin ◽  
Dialysis Patients ◽  
Cardiovascular Morbidity And Mortality

Abstract Background and Aims Retention of ß2microglobulin (ß2M), an uremic toxin in the middle molecular range, has been associated with cardiovascular morbidity and mortality in dialysis patients. Although ß2M levels are usually measured in hemodialysis patients, this practice is not common among peritoneal dialysis (PD) patients. The aim of this study is to evaluate the evolution of serum ß2M levels in incident PD patients. Method Prospective, observational study including incident PD patients in our hospital from January 2015 to October 2019. Patients with cardiorrenal syndrome or patients coming from hemodialysis were excluded. Serum ß2M levels were collected before starting PD and during follow up. Weekly KtV, residual renal function and cardiovascular events were also collected during follow up. Results We included 30 patients with a mean age of 57 +/- 17 years. 56.3% were male and 15.6% were diabetic. Mean follow up was 19.8 +/- 16.9 months. 18 patients were on continous ambulatory PD and 12 in automated PD. Mean serum ß2M levels before starting PD were 12.8 +/- 6.6 mg/l and they remained stable during follow up (12.9 +/- 5.2 mg/l, 15 +/- 4.2 mg/l, 14.3 +/- 6.9 mg/l, 10.2+/- 4.5 mg/l at month 6, 12, 24 and 36, respectively; p NS). No differences in serum ß2M levels were observed between continous ambulatory PD and automated PD. Serum ß2M levels were inversely and significantly correlated with weekly KtV (r= -0.943; p 0.009) and residual renal function (r= -0.829; p 0.042). One cardiovascular event was recorded during follow up. Conclusion Serum ß2M levels remain stable during follow up in our cohort of incident PD patients and is significantly and inversely correlated with weekly KtV and residual renal function. Serum ß2M levels monitoring could be helpful in these patients and would yield important information in this population.

scholarly journals THE RISK FACTORS AND OUTCOME OF FUNGAL PERITONITIS IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS PATIENTS

2009 ◽  
Vol 27 (1) ◽  
pp. 59-61
Author(s):  
E Indhumathi ◽  
V Chandrasekaran ◽  
D Jagadeswaran ◽  
M Varadarajan ◽  
G Abraham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Fungal Peritonitis

Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

2005 ◽  
Vol 65 (8) ◽  
pp. 739-745 ◽  
Author(s):  
F. M. Yilmaz ◽  
G. Yilmaz ◽  
M. Duranay ◽  
H. Parpucu ◽  
M. Şeneş ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Dialysis Patients

Carnitine Deficiency in Epilepsy: Risk Factors and Treatment

1995 ◽  
Vol 10 (2_suppl) ◽  
pp. 2S32-2S39 ◽  
Author(s):  
David L. Coulter
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Preliminary Data ◽  
Metabolic Diseases ◽  
Drug Effects ◽  
Carnitine Deficiency ◽  
Free Carnitine ◽  
Specific Drug ◽  
Asymptomatic Patients ◽  
The Relationship

Numerous studies have shown that plasma carnitine levels are significantly lower in patients taking valproate than in controls. Free carnitine deficiency is not uncommon in these patients and also occurs in newborns with seizures and in patients taking other anticonvulsant drugs. Carnitine deficiency in epilepsy results from a variety of etiologic factors including underlying metabolic diseases, nutritional inadequacy, and specific drug effects. The relationship between carnitine deficiency and valproate-induced hepatotoxicity is unclear. Carnitine treatment does not always prevent the emergence of serious hepatotoxicity, but it does alleviate valproate-induced hyperammonemia. These studies suggest that specific risk factors for carnitine deficiency can be identified. Preliminary data suggest that carnitine treatment may benefit high-risk, symptomatic patients and those with free carnitine deficiency. Carnitine treatment is not likely to benefit low-risk, asymptomatic patients and those with normal carnitine levels. (J Child Neurol 1995;10(Suppl):2S32-2S39).

Relative risk for cardiovascular morbidity in hemodialysis patients regarding gene polymorphism for IL-10, IL-6, and TNF

2016 ◽  
Vol 94 (10) ◽  
pp. 1106-1109 ◽  
Author(s):  
J. Tosic Dragovic ◽  
J. Popovic ◽  
P. Djuric ◽  
A. Jankovic ◽  
A. Bulatovic ◽  
...  
Keyword(s):  
Gene Polymorphism ◽  
Cerebrovascular Accident ◽  
Gene Polymorphisms ◽  
Cardiovascular Events ◽  
Medical Center ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Cardiovascular Morbidity ◽  
Number Of Patients ◽  
Tnf Gene

Uremia-related inflammation is prone to be a key factor to explain high cardiovascular morbidity in hemodialysis patients. Genetic susceptibility may be of importance, including IL-10, IL-6, and TNF. The aim was to analyze IL-10, IL-6, and TNF gene polymorphisms in a group of hemodialysis patients and to correlate the findings with cardiovascular morbidity. This study included 169 patients on regular hemodialysis at Zvezdara University Medical Center. Gene polymorphisms for IL-10, IL-6 and TNF were determined using PCR. These findings were correlated with the cardiovascular morbidity data from patient histories. Heterozygots for IL-10 gene showed significantly lower incidence of cardiovascular events (p = 0.05) and twice lower risk for development of myocardial infarction, but experienced twice higher risk for left ventricular hypertrophy. Regarding TNF gene polymorphism, patients with A allele had 1.5-fold higher risk for cerebrovascular accident and cardiovascular events and 2-fold higher risk for hypertension and peripheral vascular disease. Patients with G allele of IL-6 gene experienced 1.5-fold higher risks for cerebrovascular accident. We need studies with larger number of patients for definitive conclusion about the influence of gene polymorphisms on cardiovascular morbidity in hemodialysis patients and its importance in everyday clinical practice.

scholarly journals Atherosclerotic Risk Factors Among Ankle-Brachial Index and Toe-Brachial Index in Peritoneal Dialysis Patients

Renal Failure ◽  
2007 ◽  
Vol 29 (7) ◽  
pp. 835-841 ◽  
Author(s):  
Wen-Hung Huang ◽  
Yung-Chang Chen ◽  
Cheng-Chieh Hung ◽  
Jeng-Yi Huang ◽  
Ja-Liang Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Ankle Brachial Index ◽  
Dialysis Patients ◽  
Toe Brachial Index ◽  
Atherosclerotic Risk Factors
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