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The aim was to explore the relationships between malnutrition-inflammation-athersclerosis (MIA) syndrome and low Triiodothyronine (T3) syndrome in older peritoneal dialysis (PD) patients. A cross-sectional survey was conducted in 109 PD patients visiting our clinic between March to April, 2009. Subjective global nutritional assessment (SGA) and lean body mass (LBM), arterial pulse pressure (PP), and serum thyroid profiles were measured. All patients were divided into two groups by age (≥65 or < 65years ). There were higher prevalence of malnutrition (assessed by SGA, 28.6% vs 8.3%, P<0.05), greater PP (60.2±15.0 vs 52.0±20.2mmHg, P<0.05), and higher levels of serum C-reactive protein (CRP, 9.02±10.4 vs 3.43±5.09 mg/L, P<0.05) in 49 older patients compared to the younger. Higher prevalence of low T3 syndrome (42.9% vs 21.7%, P<0.05) and lower levels of serum free T3 (fT3, 2.41±0.35 vs 2.57±0.31 pg/ml, P<0.05) were found in older people. There were significant correlations between serum fT3 and LBM (r=0.297, P<0.05), CRP (r=−0.302, P<0.05), and PP (r=−0.284, P<0.05) in older people but not in the younger. In conclusion, Older PD patients are more susceptible to MIA syndrome and low T3 syndrome than the younger, a vicious circle may exist between these two syndromes in this population.