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Multicenter Study
. 2018 Jan 11;10(1):69.
doi: 10.3390/nu10010069.

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

Małgorzata Maraj  1 , Beata Kuśnierz-Cabala  2 , Paulina Dumnicka  3 , Agnieszka Gala-Błądzińska  4   5 , Katarzyna Gawlik  6 , Dorota Pawlica-Gosiewska  7 , Anna Ząbek-Adamska  8 , Małgorzata Mazur-Laskowska  9 , Piotr Ceranowicz  10 , Marek Kuźniewski  11
Affiliations
Multicenter Study

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

Małgorzata Maraj et al. Nutrients. .

Abstract

Malnutrition-inflammation-atherosclerosis syndrome is one of the causes of increased mortality in chronic kidney disease (CKD). The aim of the study was to assess the inflammation and nutritional status of patients in end-stage kidney disease treated with maintenance hemodialysis. The study included a group of 98 hemodialyzed patients with stage 5 CKD (38 women and 60 men). Albumin, prealbumin (PRE), and C-reactive protein (CRP) were measured in serum samples collected before mid-week dialysis. Fruit and vegetables frequency intakes were assessed with a questionnaire. CRP was above the reference limit of 5 mg/L in 53% of patients. Moreover, the Glasgow Prognostic Score (GPS) indicated the co-occurrence of inflammation and protein calorie malnutrition in 11% of patients, and the presence of either inflammation or malnutrition in 25%. The questionnaire revealed that hemodialyzed patients frequently exclude fruit and vegetables from their diets. Nearly 43% of the interviewed patients declared frequently eating vegetables, and 35% declared frequently eating fruit, a few times per week or less. The most frequently selected fruit and vegetables had a low antioxidant capacity. The strict dietary restrictions in CKD are difficult to fulfill, and if strictly followed, may lead to protein-calorie malnutrition.

Keywords: chronic kidney disease; diet; hemodialysis; inflammation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Associations between the level of physical activity reported by patients and the selected markers of malnutrition and inflammation: albumin (A); C-reactive protein (CRP) (B); prealbumin (C); and C-reactive protein to prealbumin ratio (CRP/PRE) (D). Data are shown as median, lower-upper quartile (box), non-outlier range (whiskers), and outliers (dots).
Figure 2
Figure 2
Correlations between lipid markers and selected markers of malnutrition and inflammation: HDL-cholesterol and CRP (A), triglycerides and prealbumin (B). HDL: high-density lipoprotein; CRP: C-reactive protein.
Figure 3
Figure 3
Fruit (A) and vegetables (B) frequency intake in the hemodialyzed patients’ diet.
Figure 3
Figure 3
Fruit (A) and vegetables (B) frequency intake in the hemodialyzed patients’ diet.
See this image and copyright information in PMC

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