A Case of Malnutrition Inflamation Atherosclerosis Syndrome in Home Care

Malnutrition-inflammation-atherosclerosis (MIA) syndrome is a major determinant of mortality and morbidity in patients with end-stage renal disease (ESRD). While each component alone can lead to adverse clinical outcomes, the coexistence of all components significantly reduces survival. An 81-year-old male patient with stage 5 chronic kidney disease, hypertension, and coronary artery disease was monitored through home health services; he underwent hemodialysis twice weekly, and severe MIA were identified. Despite nutritional and anti-inflammatory interventions during approximately 1 month of follow-up, the patient’s condition deteriorated, and the patient died after admission to the intensive care unit. This case highlights the critical role of primary care and family medicine in the early detection and multidisciplinary management of MIA syndrome in ESRD patients. Integration with home health services allows for early identification of malnutrition and inflammation, enabling timely intervention and referral to higher-level care. In conclusion, systematic assessment of MIA syndrome components and coordination through home health services and family medicine may facilitate early recognition and multidisciplinary management in ESRD patients.

Keywords: Family medicine end-stage renal disease, mia syndrome, home health care