Abstract:

Objective To analyze the long-term prognosis of patients with malnutrition-inflammation-atherosclerosis (MIA) syndrome who undergo the peritoneal dialysis (PD) and the effects of MIA syndrome on the all-cause mortality and cardiovascular disease (CVD) mortality. Methods Patients with end-stage renal disease (ESRD) who underwent PD between January 1, 2005 and December 31, 2009 in the Center for Peritoneal Dialysis Research of Renji Hospital, Shanghai Jiao Tong University School of Medicine were selected. The survival rate, technical survival rate, and survival time of patients without peritonitis were analyzed by the Kaplan-Meier method. Risk factors of all-cause mortality and CVD mortality were analyzed by the Cox proportional hazards models. Results A total of 256 patients were selected. There were 20 (7.8%) patients with MIA syndrome. The 1-year, 2-year, 3-year, and 5-year survival rates of patients with MIA syndrome were significantly lower than those of patients without MIA syndrome (χ²=16.200，P<0.001). The differences of technical survival rate and survival time of patients without peritonitis of patients with and without MIA syndrome were not statistically significant (P>0.05). Two complications (HR=3.624; 95%CI: 1.376-9.543; P=0.009) or 3 complications (HR=5.012, 95%CI: 1.629-15.419, P=0.005) were independent risk factors that influenced the all-cause mortality. Two complications (HR=10.324; 95%CI: 1.332-80.032; P=0.025) or 3 complications (HR=11.821; 95%CI: 1.342-104.097; P=0.026) were independent risk factors that influenced the CVD mortality. Conclusion Any two of or all of malnutrition, inflammation, and atherosclerosis are independent risk factors that influence the survival of patients undergoing the peritoneal dialysis and closely relevant to the CVD mortality.

Key words: malnutrition-inflammation-atherosclerosis syndrome, peritoneal dialysis, survival rate