Study On MIAS Status And Its Influencing Factors In Patients With Maintenance Hemodialysis

ObjectivesA cross-sectional study was conducted to analyze malnutrition,microinflammation,atherosclerosis（AS）and malnutrition-inflammation-atherosclerosis syndrome（MIAS）in maintenance hemodialysis patients in a 3A hospital in Dali,to explore the influencing factors of malnutrition,microinflammation,AS and MIAS in maintenance hemodialysis patients,and to provide ideas for clinical prevention and treatment of MIAS in maintenance hemodialysis patients.Methods156 patients with stable condition who had maintenance hemodialysis for more than3 months in the Blood purification Center of the 3A Hospital in Dali from March 2021 to March 2022 were investigated by questionnaire,and the general data,dialysis-related data,laboratory indexes,imaging indexes and malnutrition inflammation score（MIS）were obtained.Maintenance hemodialysis patients were divided into mild malnutrition group and moderate malnutrition group according to MIS score,microinflammation group and non-microinflammation group according to microinflammation,AS group and non-AS group according to atherosclerosis,MIAS group and non-MIAS group according to MIAS.The general data,dialysis-related data,laboratory indexes and imaging indexes between the two groups were analyzed and compared.Binary Logistic regression was used to analyze the influencing factors of malnutrition,microinflammation,AS and MIAS in maintenance hemodialysis patients.SPSS27.0 software was used for statistical analysis,and P<0.05 was taken as the difference with statistical significance.Results1.In this study,all maintenance hemodialysis patients were complicated with malnutrition,including mild malnutrition in 103 cases（66.03%）,moderate malnutrition in 53 cases（33.97%）,no severe malnutrition;microinflammation in 78 cases（50%）;AS in 108 cases（69.23%）;and MIAS in 57 cases（36.54%）.2.The proportion of male,diabetes,smoking and inadequate dialysis patients in mild malnutrition group was higher than that in moderate malnutrition group;Dialysis age in moderate malnutrition group was higher than that in mild malnutrition group;WC,HC,TSF,MAC,AMC,grip strength,CO₂CP,WBC,TG,HCY and MHR in mild malnutrition group were higher than those in moderate malnutrition group,while K and BUN in mild malnutrition group were lower than those in moderate malnutrition group（P<0.05）.Multivariate Logistic regression analysis showed that CO₂CP was a protective factor for malnutrition in maintenance hemodialysis patients,and the lower the CO₂CP,the higher the risk of malnutrition.3.The proportion of male,smoking patients in microinflammation group was higher than that in non-microinflammation group;BMI,WC,HC,AMC,WBC,NLR,PLT,FIB,CRP,IL-6,TG,MHR in microinflammation group were higher than those in non-microinflammation group,while ALB was lower than that in non-microinflammation group（P<0.05）.Multivariate Logistic regression analysis showed that ALB was a protective factor for microinflammation in maintenance hemodialysis patients,and the lower the ALB,the higher the risk of microinflammation.FIB was a risk factor for microinflammation in maintenance hemodialysis patients.The higher the FIB,the higher the risk of microinflammation.4.The proportion of male,over 45 years old,diabetes and smoking patients in AS group was higher than that in non-AS group;NLR,PLR and IMT in AS group were higher than those in non-AS group,while i PTH and SCr were lower than those in non-AS group（P<0.05）.Multivariate Logistic regression analysis showed that age was the risk factor for AS in maintenance hemodialysis patients.With the increase of age,the risk of AS in maintenance hemodialysis patients increased.5.The proportion of male,over 45 years old and smoking patients in the MIAS group was higher than that in the non-MIAS group.WC,MAC,WBC,PLT,FIB,CRP,IL-6,TG,LDL-C and MHR of MIAS group were higher than those of non-MIAS group,while SCR was lower than that of non-MIAS group（P<0.05）.Multivariate logistic regression analysis found that FIB and IL-6 were the risk factors for MIAS in maintenance hemodialysis patients.The higher the FIB and IL-6,the higher the risk of MIAS.Conclusions1.The incidence of malnutrition,microinflammation,AS and MIAS in maintenance hemodialysis patients is high.2.CO₂CP may be a protective factor for malnutrition in maintenance hemodialysis patients.3.ALB may be a protective factor for microinflammation in maintenance hemodialysis patients.FIB may be a risk factor for microinflammation in maintenance hemodialysis patients.4.Age may be the risk factor for AS in maintenance hemodialysis patients.5.FIB and IL-6 may be the risk factors for MIAS in maintenance hemodialysis patients.