Malnutrition, inflammation, and atherosclerosis syndrome components predicts poor cardiovascular outcomes in patients with stage 3-5 chronic kidney disease

Solak Y., Yilmaz M.I., Caglar K., Saglam M., Yaman H., Sonmez A., Unal H.U., Gok M., Gaipov A., Kayrak M., Eyileten T., Turk S., Vural A.

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Introduction and Aims: Malnutrition, inflammation, atherosclerosis syndrome (MIA) is common in end-stage renal disease patients and related to increased cardiovascular (CV) mortality. Several studies investigated frequency of MIA and related poor outcomes in hemodialysis and peritoneal dialysis patients. However, there is no study in the literature to date examining prevalence of MIA and frequency of individual components of MIA in patients with chronic kidney disease (CKD). Thus, we aimed to determine prevalence of MIA components and their predictive ability of poor outcomes in a cohort of stage 3-5 CKD patients. Methods: This is a retrospective longitudinal observational study. 269 patients included in the final analysis. There were 87 patients with stage 3, 86 patients with stage 4, and 96 patients with stage 5 CKD. None of the patients in stage-5 were undergoing hemodialysis. Cardiovascular outcomes were determined from the day of examination onwards, with a mean follow-up period of 38 (range 2 to 43) months. Three components of MIA syndrome were defined as presence of hypoalbuminemia (<3.5 g/dL), increased inflammation (CRP >10 ng/dL) and intima media thickness of carotid artery (IMT>9 mm). Results: Cardiovascular mortality (n=29) was defined as death due to coronary heart disease (18), sudden death (3), stroke (5) or complicated peripheral vascular disease (3). In addition to the 14 cardiovascular deaths, 74 non-fatal cardiovascular events were registered during the follow-up as follows: stroke (19); myocardial infarction (45); peripheral vascular disease (8) and aortic aneurysm (2). There was only 20 patients (7%) who had none of the MIA components (MIA-0). Other patients had at least one component of MIA (185 patients had 1 (MIA-1), 49 had 2 (MIA-2) and 15 patients had all three components (MIA-3)). Comonent numbers of MIA significantly increased from stage-3 CKD to stage-5. Only 8% of stage-5 patients were MIA-0. Composite CV adverse events significantly increased while number of MIA components increase (20% in MIA-0, 80% in MIA-3, p

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Chronic Renal Insufficiency
Malnutrition
Atherosclerosis
Inflammation
Peripheral Vascular Diseases
Renal Dialysis
Stroke
Hypoalbuminemia
Mortality
Aortic Aneurysm
Peritoneal Dialysis
Sudden Death
Carotid Arteries
Chronic Kidney Failure
Observational Studies
Coronary Disease
Longitudinal Studies

Keywords

  • C reactive protein
  • aortic aneurysm
  • arterial wall thickness
  • atherosclerosis
  • cardiovascular mortality
  • carotid artery
  • cerebrovascular accident
  • chronic kidney failure
  • death
  • edetic acid
  • evoked response audiometry
  • examination
  • follow up
  • glomerulus filtration rate
  • heart infarction
  • hemodialysis
  • hemodialysis patient
  • human
  • hypoalbuminemia
  • inflammation
  • ischemic heart disease
  • kidney failure
  • log rank test
  • malnutrition
  • observational study
  • patient
  • peripheral vascular disease
  • peritoneal dialysis
  • prevalence
  • sudden death
  • survival
  • survival rate

Cite this

Malnutrition, inflammation, and atherosclerosis syndrome components predicts poor cardiovascular outcomes in patients with stage 3-5 chronic kidney disease. / Y., Solak; M.I., Yilmaz; K., Caglar; M., Saglam; H., Yaman; A., Sonmez; H.U., Unal; M., Gok; A., Gaipov; M., Kayrak; T., Eyileten; S., Turk; A., Vural.

Nephrology Dialysis Transplantation. 2012. p. ii383 (Nephrology Dialysis Transplantation; Vol. 27).

Research output: Chapter in Book/Report/Conference proceedingChapter

Y., Solak ; M.I., Yilmaz ; K., Caglar ; M., Saglam ; H., Yaman ; A., Sonmez ; H.U., Unal ; M., Gok ; A., Gaipov ; M., Kayrak ; T., Eyileten ; S., Turk ; A., Vural. / Malnutrition, inflammation, and atherosclerosis syndrome components predicts poor cardiovascular outcomes in patients with stage 3-5 chronic kidney disease. Nephrology Dialysis Transplantation. 2012. pp. ii383 (Nephrology Dialysis Transplantation).
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abstract = "Introduction and Aims: Malnutrition, inflammation, atherosclerosis syndrome (MIA) is common in end-stage renal disease patients and related to increased cardiovascular (CV) mortality. Several studies investigated frequency of MIA and related poor outcomes in hemodialysis and peritoneal dialysis patients. However, there is no study in the literature to date examining prevalence of MIA and frequency of individual components of MIA in patients with chronic kidney disease (CKD). Thus, we aimed to determine prevalence of MIA components and their predictive ability of poor outcomes in a cohort of stage 3-5 CKD patients. Methods: This is a retrospective longitudinal observational study. 269 patients included in the final analysis. There were 87 patients with stage 3, 86 patients with stage 4, and 96 patients with stage 5 CKD. None of the patients in stage-5 were undergoing hemodialysis. Cardiovascular outcomes were determined from the day of examination onwards, with a mean follow-up period of 38 (range 2 to 43) months. Three components of MIA syndrome were defined as presence of hypoalbuminemia (<3.5 g/dL), increased inflammation (CRP >10 ng/dL) and intima media thickness of carotid artery (IMT>9 mm). Results: Cardiovascular mortality (n=29) was defined as death due to coronary heart disease (18), sudden death (3), stroke (5) or complicated peripheral vascular disease (3). In addition to the 14 cardiovascular deaths, 74 non-fatal cardiovascular events were registered during the follow-up as follows: stroke (19); myocardial infarction (45); peripheral vascular disease (8) and aortic aneurysm (2). There was only 20 patients (7{\%}) who had none of the MIA components (MIA-0). Other patients had at least one component of MIA (185 patients had 1 (MIA-1), 49 had 2 (MIA-2) and 15 patients had all three components (MIA-3)). Comonent numbers of MIA significantly increased from stage-3 CKD to stage-5. Only 8{\%} of stage-5 patients were MIA-0. Composite CV adverse events significantly increased while number of MIA components increase (20{\%} in MIA-0, 80{\%} in MIA-3, p",
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author = "Solak Y. and Yilmaz M.I. and Caglar K. and Saglam M. and Yaman H. and Sonmez A. and Unal H.U. and Gok M. and Gaipov A. and Kayrak M. and Eyileten T. and Turk S. and Vural A.",
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TY - CHAP

T1 - Malnutrition, inflammation, and atherosclerosis syndrome components predicts poor cardiovascular outcomes in patients with stage 3-5 chronic kidney disease

AU - Y., Solak

AU - M.I., Yilmaz

AU - K., Caglar

AU - M., Saglam

AU - H., Yaman

AU - A., Sonmez

AU - H.U., Unal

AU - M., Gok

AU - A., Gaipov

AU - M., Kayrak

AU - T., Eyileten

AU - S., Turk

AU - A., Vural

PY - 2012

Y1 - 2012

N2 - Introduction and Aims: Malnutrition, inflammation, atherosclerosis syndrome (MIA) is common in end-stage renal disease patients and related to increased cardiovascular (CV) mortality. Several studies investigated frequency of MIA and related poor outcomes in hemodialysis and peritoneal dialysis patients. However, there is no study in the literature to date examining prevalence of MIA and frequency of individual components of MIA in patients with chronic kidney disease (CKD). Thus, we aimed to determine prevalence of MIA components and their predictive ability of poor outcomes in a cohort of stage 3-5 CKD patients. Methods: This is a retrospective longitudinal observational study. 269 patients included in the final analysis. There were 87 patients with stage 3, 86 patients with stage 4, and 96 patients with stage 5 CKD. None of the patients in stage-5 were undergoing hemodialysis. Cardiovascular outcomes were determined from the day of examination onwards, with a mean follow-up period of 38 (range 2 to 43) months. Three components of MIA syndrome were defined as presence of hypoalbuminemia (<3.5 g/dL), increased inflammation (CRP >10 ng/dL) and intima media thickness of carotid artery (IMT>9 mm). Results: Cardiovascular mortality (n=29) was defined as death due to coronary heart disease (18), sudden death (3), stroke (5) or complicated peripheral vascular disease (3). In addition to the 14 cardiovascular deaths, 74 non-fatal cardiovascular events were registered during the follow-up as follows: stroke (19); myocardial infarction (45); peripheral vascular disease (8) and aortic aneurysm (2). There was only 20 patients (7%) who had none of the MIA components (MIA-0). Other patients had at least one component of MIA (185 patients had 1 (MIA-1), 49 had 2 (MIA-2) and 15 patients had all three components (MIA-3)). Comonent numbers of MIA significantly increased from stage-3 CKD to stage-5. Only 8% of stage-5 patients were MIA-0. Composite CV adverse events significantly increased while number of MIA components increase (20% in MIA-0, 80% in MIA-3, p

AB - Introduction and Aims: Malnutrition, inflammation, atherosclerosis syndrome (MIA) is common in end-stage renal disease patients and related to increased cardiovascular (CV) mortality. Several studies investigated frequency of MIA and related poor outcomes in hemodialysis and peritoneal dialysis patients. However, there is no study in the literature to date examining prevalence of MIA and frequency of individual components of MIA in patients with chronic kidney disease (CKD). Thus, we aimed to determine prevalence of MIA components and their predictive ability of poor outcomes in a cohort of stage 3-5 CKD patients. Methods: This is a retrospective longitudinal observational study. 269 patients included in the final analysis. There were 87 patients with stage 3, 86 patients with stage 4, and 96 patients with stage 5 CKD. None of the patients in stage-5 were undergoing hemodialysis. Cardiovascular outcomes were determined from the day of examination onwards, with a mean follow-up period of 38 (range 2 to 43) months. Three components of MIA syndrome were defined as presence of hypoalbuminemia (<3.5 g/dL), increased inflammation (CRP >10 ng/dL) and intima media thickness of carotid artery (IMT>9 mm). Results: Cardiovascular mortality (n=29) was defined as death due to coronary heart disease (18), sudden death (3), stroke (5) or complicated peripheral vascular disease (3). In addition to the 14 cardiovascular deaths, 74 non-fatal cardiovascular events were registered during the follow-up as follows: stroke (19); myocardial infarction (45); peripheral vascular disease (8) and aortic aneurysm (2). There was only 20 patients (7%) who had none of the MIA components (MIA-0). Other patients had at least one component of MIA (185 patients had 1 (MIA-1), 49 had 2 (MIA-2) and 15 patients had all three components (MIA-3)). Comonent numbers of MIA significantly increased from stage-3 CKD to stage-5. Only 8% of stage-5 patients were MIA-0. Composite CV adverse events significantly increased while number of MIA components increase (20% in MIA-0, 80% in MIA-3, p

KW - C reactive protein

KW - aortic aneurysm

KW - arterial wall thickness

KW - atherosclerosis

KW - cardiovascular mortality

KW - carotid artery

KW - cerebrovascular accident

KW - chronic kidney failure

KW - death

KW - edetic acid

KW - evoked response audiometry

KW - examination

KW - follow up

KW - glomerulus filtration rate

KW - heart infarction

KW - hemodialysis

KW - hemodialysis patient

KW - human

KW - hypoalbuminemia

KW - inflammation

KW - ischemic heart disease

KW - kidney failure

KW - log rank test

KW - malnutrition

KW - observational study

KW - patient

KW - peripheral vascular disease

KW - peritoneal dialysis

KW - prevalence

KW - sudden death

KW - survival

KW - survival rate

UR - http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70766431 http://dx.doi.org/10.1093/ndt/gfs236

UR - http://www.mendeley.com/research/malnutrition-inflammation-atherosclerosis-syndrome-components-predicts-poor-cardiovascular-outcomes

U2 - 10.1093/ndt/gfs236 LK - http://sfx.library.uu.nl/utrecht?sid=EMBASE&issn=09310509&id=doi:10.1093%2Fndt%2Fgfs236&atitle=Malnutrition%2C+inflammation%2C+and+atherosclerosis+syndrome+components+predicts+poor+cardiovascular+outcomes+in+patients+with+stage+3-5+chronic+kidney+disease&stitle=Nephrol.+Dial.+Transplant.&title=Nephrology+Dialysis+Transplantation&volume=27&issue=&spage=ii383&epage=&aulast=Solak&aufirst=Yalcin&auinit=Y.&aufull=Solak+Y.&coden=&isbn=&pages=ii383-&date=2012&auinit1=Y&auinitm=

DO - 10.1093/ndt/gfs236 LK - http://sfx.library.uu.nl/utrecht?sid=EMBASE&issn=09310509&id=doi:10.1093%2Fndt%2Fgfs236&atitle=Malnutrition%2C+inflammation%2C+and+atherosclerosis+syndrome+components+predicts+poor+cardiovascular+outcomes+in+patients+with+stage+3-5+chronic+kidney+disease&stitle=Nephrol.+Dial.+Transplant.&title=Nephrology+Dialysis+Transplantation&volume=27&issue=&spage=ii383&epage=&aulast=Solak&aufirst=Yalcin&auinit=Y.&aufull=Solak+Y.&coden=&isbn=&pages=ii383-&date=2012&auinit1=Y&auinitm=

M3 - Chapter

SN - 0931-0509

T3 - Nephrology Dialysis Transplantation

SP - ii383

BT - Nephrology Dialysis Transplantation

ER -