ABSTRACT
Objective To investigate the potential correlation between serum magnesium and malnutrition-inflammation-atherosclerosis (MIA) syndrome in maintenance hemodialysis (MHD) patients.Methods A total of 120 patients who received MHD in Department of Blood Purification of Beijing Chaoyang Hospital from March to August 2013 were enrolled.Anthropometric and laboratory data were collected for the analysis of correlation between serum magnesium and indicators relating to malnutrition,chronic inflammation,and atherosclerosis,and the analysis of relevant factors of MIA syndrome.Results In the 120 MHD patients,the mean serum magnesium level was (1.11 ±0.14) mmol/L.44 patients had malnutrition (36.7％),whose serum magnesium level was significantly lower than that of patients in normal nutritious status [(1.04 ±0.12) mmol/L vs.(1.14 ±0.15) mmol/L,t =3.576,P =0.001] ; 43 patients had chronic inflammation (35.8％),with serum magnesium level significantly lower than that of patients without inflammation [(1.07 ±0.13) mmol/L vs.(1.13 ±0.15) mmol/L,t =2.138,P =0.035]; 79 patients had atherosclerosis (65.8％),whose serum magnesium level was significantly lower than that of patients without atherosclerosis [(1.08 ±0.12) mmol/L vs.(1.15 ±0.08) mmol/L,t =0.385,P =0.019] ; and 26 patients had MIA syndrome (21.7％),whose serum magnesium level was significantly lower than that of non-MIA patients [(1.02 ± 0.10) mmol/L vs.(1.13 ± 0.14) mmol/L,t =3.534,P =0.001].Serum magnesium level was found negatively correlated with high-sensitivity C-reactive protein (hs-CRP,r =-0.237,P =0.010) and carotid intima-media thickness (IMT,r =-0.331,P =0.000),and positively correlated with serum albumin,blood urea nitrogen,serum creatinine,uric acid,serum potassium,triceps skin-fold thickness,mid-arm circumference,mid-arm muscle circumference and hemoglobin (r =0.191,P =0.037; r =0.345,P =0.000; r =0.242,P=0.008; r =0.282,P=0.002; r=0.254,P=0.005; r=0.265,P=0.011; r=0.233,P=0.018; r=0.282,P=0.007; r=0.374,P =0.000).Multivariate logistic regression analysis showed that age (OR =1.142,95％ CI =1.026-1.271,P=0.049),hs-CRP (OR=1.415,95％ CI=1.152-1.740,P=0.001),IMT (OR =1.386,95％ CI=1.009-1.904,P=0.044),serum albumin (OR =0.944,95％ CI=0.910-0.978,P=0.002) and serum magnesium (OR =0.886,95％ CI =0.788-0.996,P =0.042) were related factors of MIA syndrome.Conclusions Serum magnesium level is correlated to malnutrition,inflammation,atherosclerosis,and MIA syndrome in MHD patients.
ABSTRACT
Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.