The Japanese Journal of Clinical Dialysis Vol.24 No.9(2-1)

Theme New Insights into Uremic Conditions and Their Therapeutic Targets
Title Malnutrition-inflammation-atherosclerosis (MIA) syndrome
Publish Date 2008/08
Author Makoto Watanabe Division of Nephrology, Department of Internal Medicine, Showa University School of Medicine
Author Yuki Hirai Division of Nephrology, Department of Internal Medicine, Showa University School of Medicine
Author Hisako Nagai Division of Nephrology, Department of Internal Medicine, Showa University School of Medicine
Author Tadao Akizawa Division of Nephrology, Department of Internal Medicine, Showa University School of Medicine
[ Summary ] Cardiovascular disease (CVD) is the most frequent cause of death in dialysis patients. Inflammation and malnutrition are closely associated with the development of atherosclerosis (a common cause of CVD). Higher risks of mortality due to CVD are observed in patients with higher CRP or lower serum albumin levels. Because of this association, MIA syndrome has been suggested as a therapeutic target for dialysis patients. Inflammation results from pathophysiological circumstance associated with renal failure and dialysis treatment itself. Bioincompatible materials used for dialysis therapy or an inflow of bacterial substances from the dialysate into the patient are sources of inflammation. For the treatment of MIA syndrome, the prevention of inflammation and malnutrition is most important. Control of inflammatory cytokines to mediate malnutrition and atherosclerosis may be a future therapeutic tool for this syndrome.
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