Effect of MIA syndrome on prognosis of maintenance hemodialysis patients

Objective To study the effect of maintenance hemodialysis (MHD) patients complicated with malnutrition, inflammation and atherosclerosis (MIA) syndrome on the prognosis.Methods The patients were recruited who have made MHD for more than three months in Hemopurification Center of our hospital between January, 2013 and January, 2016. If his or her serum albumin was <35 g/L, malnutrition was defined; If his or her C-reactive protein was ≥ 8 mg/L, micro-inflammation was defined. The cerebrovascular diseases include coronary artery diseases, peripheral vascular diseases and cerebrovascular diseases. The patients were divided into two groups based on above standards:observation group and control group. The survival rate and all-cause mortality risk in one year, two years and three years were compared.Results There were 71 patients in observation group45 males and 26 females; mean age of (60.1±15.1) years; mean hemodialysis vintage of (62.75±36.87) months; mean hemoglobin of (96.56±17.27) g/L, and there were 185 patients in control group110 males and 75 females; mean age of (55.8±15.4) years; mean hemodialysis vintage of (51.43±27.74) months; mean hemoglobin of (106.09±18.3) g/L. The patients were older(60.1±15.1) vs. (55.8±15.4), P<0.05, hemodialysis vintage was longer(62.75±36.87) vs. (51.43±27.74), P<0.05, and hemoglobin was lower(96.56±17.27) vs. (106.09±18.3), P<0.05 in observation group than in control group. The one-, two-and three-year survival rate was 99.5%, 94.1% and 88.1% in control group, and 95.8%, 83.1% and 80.3% in observation group, respectiely. The survival rate in observation group was obviously lower than in control group (Log rank13.419, P=0.000). As compared with control group, the all-cause mortality risk of patients in observation group was 2.86 (95% CI, 1.59-5.17, P=0.000), which still had statistical significance after adjustment (HR 2.18, 95% CI, 1.13-4.21, P=0.210).Conclusions The MIA syndrome existing in MHD patients is an independent risk factor for their all-cause mortality, which significantly impacts the long-term prognosis of the HD patients, and is an important reason for the increased fatality rate.