Inflammatory Cytokines and Malnutrition as Related to Risk for Coronary Heart Disease in Hemodialysis Patients

Background. Malnutrition and inflammation are associated with end-stage renal disease (ESRD). Interleukin (IL)-6 and tumor necrosis factor-alfa (TNF) powerfully predict death from cardiovascular disease. Aim of our study was to establish association between markers of inflammation and parameters of malnutrition in hemodialysis patients. Methods. The study population consisted of 42 hemodialysis patients with different parameters of malnutrition and mean age 55±8 with dialysis duration 6,25±2. Blood samples were taken after an overnight fast and plasma lipid profiles were measured: total cholesterol, LDL cholesterol, high-density lipoprotein (HDL) cholesterol, and tryglicerides, using conventional enzymatic methods. Serum urea and creatinine levels were also measured by the routine procedures of our laboratory. Inflammatory cytokines, IL-6 and TNF, and parathyroid hormone were measured by photometric enzymelinked immunosorbent assay (ELISA). We used standard Doppler echo examinations to determine of left ventricular mass index (LVMi). Results. Malnourished patients had significantly increased cardiovascular disease and carotid plaques. Significant positive relations between TNFand LDL/HDL cholesterol was found in the groups (p< 0.05) and positive correlation between IL-6 and LVMi (p<0.05). Conclusions. In summary, this cross-sectional study in hemodialysis patients has demonstrated a high prevalence of malnutrition, inflammation, carotid plaques and cardiovascular disease. Malnourished dialysis patients are more often with cardiovascular disease and carotid plaques and have elevated inflammatory cytokines which all may increase the risk of atherosclerotic vascular disease.