Relation between Malnutrition–Inflammation–Atherosclerosis (MIA complex) in Diabetic Patients with Peritoneal Dialysis

Objective: Atherosclerosis disease, inflammation and malnutrition have strong association with end stage renal disease (ESRD). Diabetes mellitus (DM) is the most commonly ESRD causes. Diabetic nephropathy (DN) could be associated with inflammation. Type 2 diabetic patients with advanced nephropathy show the highest levels of inflammatory markers. This study was designed to determine the association between malnutrition&ndash;inflammation&ndash;atherosclerosis (MIA complex) in Diabetic patients with peritoneal dialysis. Materials and Methods: Fifty seven diabetic patients on peritoneal dialysis were investigated and demographic variables (age, gender, BMI and dialysis duration), Inflammatory markers (cholesterol, Albumin and CRP) were measured in routine protocol. CIMT (Carotid Intima-Media Thickness) and plaque number were evaluated by B-Mode ultrasonography (7.5 -10 MHZ probe) in supine position. Results: the mean age (Standard deviation) of patients was 51&plusmn;17.3 years. The mean time on dialysis was 26.12 &plusmn;25.42 (range 4&ndash;120) months. The mean of IMT was 5.98&plusmn;1.17 mm and mean of plaques were 1.80&plusmn;2.01. Results of Analysis of variance (ANOVA) showed that older patients have more carotid plaques (P-Value= 0.000). There was a significant relation between serum albumin and number of plaques (P-Value=0.043). CIMT and number of plaque revealed significant correlation with age, serum albumin and dialysis duration (P<0.05). Conclusion: Our findings showed, in diabetic patients on peritoneal dialysis, carotid atherosclerosis (CIMT and Number of plaque) is associated with some inflammation, malnutrition markers.