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The MIA (Malnutrition, Inflammation, Atherosclerosis) Syndrome and Mortality in a Dialysis Patient

Purpose: To evaluate a patient who is being dialyzed for chronic renal failure for elements of the MIA syndrome to predict mortality as reported by de Mustert et al.

Description

Elements of the MIA Syndrome (triad of malnutrition, inflammation and atherosclerosis) impact prognosis in patients undergoing dialysis for renal failure. De Mutsert et al correlated the number of elements with mortality risk in these patients. The authors are from Leids Universitair Medisch Centrum at Leiden.


Parameters at baseline:

(1) malnutrition

(2) inflammation (indicated by C-reactive protein, CRP)

(3) atherosclerosis

 

Parameter

Finding

Points

malnutrition

absent

0

 

present

1

inflammation

absent (CRP < 10 mg/L)

0

 

present (CRP >= 10 mg/L)

1

atherosclerosis

absent

0

 

present

1

 

number of risk factors =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 3

• The risk of death increases as the number of risk factors increase.

• In theory addressing each issue should reduce mortality.

 

Total Risk Score

Annual Mortality Rate

0

7%

1

14%

2

23%

3

45%

 


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Specialty

Objective

ICD-10