الفهرس 
Malnutrition-inflammation complex syndrome (MICS or MIA) in hemodialysis patientsOnly 14 pages are availabe for public view
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Abstract
AFFILIATIONS
Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Hesham Mohamed Elsayed, MD. Professor of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. E-mail: hesham.elsayed@med.asu.edu.eg
Magdy Mohamed ElSharkawy, MD. Professor of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. E-mail: MagdyElSharkawy@med.asu.edu.eg
Aber Halim Baqy, MD. Professor of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. E-mail: aberhalim@med.asu.edu.eg
Abdelrahman Ali Elbraky, MD. Lecturer of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. E-mail: elbraky@med.asu.edu.eg
Mohamed Atef Abd El-Mohsen, MD. Lecturer of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.E-mail: mohamedatef99@med.asu.edu.eg
Meryhan Osama Mohamed Abd Elmonem, MBBCh, MSc. Assistant lecturer of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. E-mail: meryhan.osama@med.asu.edu.eg
ABSTRACT
Background:Hemodiafiltration (HDF) yields an increased overall solute clearance compared with hemodialysis (HD).Kidney transplantation offers an improved quality of life in comparison to dialysis.In end-stage-renal-disease(ESRD),inflammation has become recognized.High-sensitivity C-reactive protein(Hs-CRP) is a biomarker of inflammation which plays a key role in atherosclerosis. Subjective global assessment(SGA) which is highly correlated with quality of life,was applied to evaluate the common malnutrition-inflammation complex syndrome(MICS) occurring in renal patients.
Aim of the work:The aim of the current study was to compare between different renal replacement modalities as regards inflammatory markers and quality of life (QOL) evaluated by SGA score
Patients and Methods:A cross-sectional study was conducted on 75 patients;25 patients with ESRD on HD,25 patients with ESRD on HDF and 25 early post-renal-transplant patients.Inflammatory marker(Hs-CRP) was withdrawn and SGA was applied
Results:Hs-CRP was significantly higher in HD patients;median 14.2(7.4 - 16.9 mg/L) than HDF;median 6.3(4.1 - 14.3 mg/L) and post-renal-transplant patients median 5.2(3.3 - 8.6 mg/L)(P= 0.003).Post-renal-transplant patients had better QOL;SGA score A(normal)= 100%, in comparison with dialysis groups.Moreover,when comparing SGA in both dialysis modalities,HDF group had better QOL as 76% of them had normal nutritional status(SGA score A) in comparison with the HD group who had only 32% patients with SGA score A (normal) with highly significant statistical differences between the 3 groups(P= 0.000)
Conclusions:Kidney transplantation offers improved QOL for ESRD patients in comparison to dialysis.Moreover,for patients on dialysis,HDF modality demonstrates beneficial effect on QOL in comparison to HD