Abstract:

Objective To investigate the impact of malnutrition, inflammation and cardiovascular diseases on the prognosis of elder peritoneal dialysis patients. Methods A cross-sectional study was performed in 50 clinically stable continuous ambulatory peritoneal dialysis (CAPD) patients. Their nutritional status, chronic inflammation and cardiovascular diseases were evaluated. They were divided into two age groups, group A (>65 years) and group B (<65 years). In group A, patients complicated with malnutrition, inflammation and cardiovascular diseases (arthrosclerosis) (MIA syndrome) were further assigned in group A1, and those without MIA syndrome in group A2. Patients were followed up for 12 months. Results During the 12-month follow-up period, 10 (20%) patients died, and 2 patients (4%) changed to hemodialysis. The follow-up was lost in 1 patient (2%), and CADP was continued in our hospital in 37 patients (74%). The mean survival rate was higher in group B than in group A. Malnutrition (SGA 2 to 3) was found in 64% patients, and C-reactive protein (CRP) higher than normal (8.2 mg/l) indicating inflammation status was detected in 32% patients. Cardiovascular diseases including chronic heart failure, coronary heart disease, cerebral infarction sequelae and peripheral vascular sclerosis were found in 58% patients. The prevalence of malnutrition was 75% in group A and 44.4% in group B, and that of cardiovascular diseases was 68.8% in group A and 38.9% in group B (P<0.05). Serum CRP was 7.6±15.2 mg/L in group A and 2.4±3.9mg/L in group B (P<0.01). MIA syndrome was identified in 22% patients, of whom all were in group A. The survival rate was lower in group A1 than in groups A2 and B (P<0.01), but was similar between group A2 and group B (P>0.05). Conclusion Malnutrition, inflammation and cardiovascular diseases were frequently seen in CAPD of elder patients. MIA syndrome was the principal factor leading to the lower survival rate in CAPD of elder patients than in CAPD of younger patients. Therefore, diagnosis and treatment of MIA syndrome, especially in CAPD of elder patients, should be emphasized.

Key words: Elder, Inflammation, Nutrition, MIA syndrome