Malnutrition-inflammation-atherosclerosis syndrome in patients with end-stage renal disease.

Malnutrition-inflammation-atherosclerosis (MIA) syndrome is where three dominant clinical entities which occur in patients with end-stage renal disease--malnutrition, inflammation and atherosclerosis--coexist and interact with each other. This literature review aims to present the factors which are responsible for the existence of MIA syndrome in patients with end-stage chronic kidney disease (CKD) on renal replacement therapy. Studies have shown that the main role in the pathogenesis of the MIA syndrome is played by inflammatory cytokines. The main inflammatory cytokines are tumour necrosis factor-a, interleukin-1 and interleukin-6. The following work examines these cytokines, indicating their main characteristics and the basic mode of action in patients with end-stage CKD as well as the further development of the syndrome. The existence of this syndrome is responsible for the high rates of morbidity and mortality in this group of patients who reach a level comparable with persons suffering from metastatic cancer.