Inflammation , Atherosclerosis and Malnutrition Syndrome among Iraqi Patients on Hemodialysis: A Prospective Clinical Study

Abstract

Background: In dialysis patients, the main cause of death is cardiovascular diseases, however, several studies documented a role for malnutrition and inflammation in the occurrence of atherosclerosis, which in turn leads to increased mortality rates among dialysis patients. Objective: To estimate the prevalence of inflammation, malnutrition, and atherosclerosis among Iraqi patients with renal failure on maintenance hemodialysis
Materials and methods: This was a prospective clinical study conducted during a period of 18 months in Karbala. All patients were followed up and various information related to them (age, gender, medical condition, ...) were recorded. In addition, Doppler sonar , echocardiography and other necessary investigations were performed accordingly. Statistical analysis was done using the statistical package for social sciences (SPSS 25), All statistical procedures and correlation analysis were performed at a level of signifciance of 0.05. Results: We found atherosclerosis in 54 patients (62.8%), Malnutrition in 46 (53.5%) and inflammation in 39 patients (45.3%). C-reactive protein (CRP) was elevated in 45 cases (52.3%). Low level of albumin reported in 61.6% of cases. A significant negative (inverse) correlation was found between CRP and albumin, while a significant positive correlation was found between CRP and atherosclerosis. Conclusions: A high percentage of hemodialysis patients have malnutrition, inflammation, and atherosclerosis. A significant inter-correlation between these three conditions in ESRD patients. High levels of CRP was associated with hypoalbuminemia, which reflect the association between inflammation and malnutrition.