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Geriatric Nutritional Risk Index Is a Simple Predictor of Mortality in Chronic Hemodialysis Patients.
Blood Purif. 2015; 39(4):281-7.BP

Abstract

BACKGROUND

Malnutrition is common in hemodialysis (HD) patients, and it is associated with increasing risk of mortality. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. The aim of this study was to examine the reliability of the GNRI as a mortality predictor in a Japanese HD cohort.

METHODS

We prospectively examined the GNRI of 332 maintenance HD patients aged 65.4 ± 13.2, 213 males, and followed up on them for 36 months. The patients were divided into quartiles (Q) according to GNRI values (Q1: <91.6, Q2: 91.7-97.0, Q3: 97.1-102.2, Q4: >102.3). Predictors for all-cause mortality were examined using Kaplan-Meier and Cox proportional-hazards analyses.

RESULTS

The GNRI presented a normal distribution. During the follow-up period of 36 months, 76 patients died. The overall mortality at the end of the 3-year observational period was 22.3%. At the 3-year follow-up period, Kaplan-Meier survival rates for all-cause mortality were 72.3, 79.3, 84.9 and 92.6% in Q1, Q2, Q3, and Q4, respectively (p = 0.0067). Multivariate Cox proportional-hazards analysis demonstrated that the GNRI was a significant predictor of adjusted all-cause mortality (HR 0.958; 95% CI 0.929-0.989, p = 0.0073).

CONCLUSIONS

The results of the present study demonstrate that the GNRI is a strong predictor of overall mortality in HD patients. However, cardiovascular mortality was not associated with GNRI values, and did not differ among the GNRI quartiles. The GNRI score can be considered a simple and reliable marker of predictor for mortality risk in Japanese HD patients.

Authors+Show Affiliations

Department of Nephrology, Jyoban Hospital, Fukushima, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25925239

Citation

Komatsu, Mizuki, et al. "Geriatric Nutritional Risk Index Is a Simple Predictor of Mortality in Chronic Hemodialysis Patients." Blood Purification, vol. 39, no. 4, 2015, pp. 281-7.
Komatsu M, Okazaki M, Tsuchiya K, et al. Geriatric Nutritional Risk Index Is a Simple Predictor of Mortality in Chronic Hemodialysis Patients. Blood Purif. 2015;39(4):281-7.
Komatsu, M., Okazaki, M., Tsuchiya, K., Kawaguchi, H., & Nitta, K. (2015). Geriatric Nutritional Risk Index Is a Simple Predictor of Mortality in Chronic Hemodialysis Patients. Blood Purification, 39(4), 281-7. https://doi.org/10.1159/000381798
Komatsu M, et al. Geriatric Nutritional Risk Index Is a Simple Predictor of Mortality in Chronic Hemodialysis Patients. Blood Purif. 2015;39(4):281-7. PubMed PMID: 25925239.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Geriatric Nutritional Risk Index Is a Simple Predictor of Mortality in Chronic Hemodialysis Patients. AU - Komatsu,Mizuki, AU - Okazaki,Masayuki, AU - Tsuchiya,Ken, AU - Kawaguchi,Hiroshi, AU - Nitta,Kosaku, Y1 - 2015/04/29/ PY - 2014/12/16/received PY - 2015/03/20/accepted PY - 2015/5/1/entrez PY - 2015/5/1/pubmed PY - 2016/3/25/medline SP - 281 EP - 7 JF - Blood purification JO - Blood Purif VL - 39 IS - 4 N2 - BACKGROUND: Malnutrition is common in hemodialysis (HD) patients, and it is associated with increasing risk of mortality. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. The aim of this study was to examine the reliability of the GNRI as a mortality predictor in a Japanese HD cohort. METHODS: We prospectively examined the GNRI of 332 maintenance HD patients aged 65.4 ± 13.2, 213 males, and followed up on them for 36 months. The patients were divided into quartiles (Q) according to GNRI values (Q1: <91.6, Q2: 91.7-97.0, Q3: 97.1-102.2, Q4: >102.3). Predictors for all-cause mortality were examined using Kaplan-Meier and Cox proportional-hazards analyses. RESULTS: The GNRI presented a normal distribution. During the follow-up period of 36 months, 76 patients died. The overall mortality at the end of the 3-year observational period was 22.3%. At the 3-year follow-up period, Kaplan-Meier survival rates for all-cause mortality were 72.3, 79.3, 84.9 and 92.6% in Q1, Q2, Q3, and Q4, respectively (p = 0.0067). Multivariate Cox proportional-hazards analysis demonstrated that the GNRI was a significant predictor of adjusted all-cause mortality (HR 0.958; 95% CI 0.929-0.989, p = 0.0073). CONCLUSIONS: The results of the present study demonstrate that the GNRI is a strong predictor of overall mortality in HD patients. However, cardiovascular mortality was not associated with GNRI values, and did not differ among the GNRI quartiles. The GNRI score can be considered a simple and reliable marker of predictor for mortality risk in Japanese HD patients. SN - 1421-9735 UR - https://www.unboundmedicine.com/medline/citation/25925239/Geriatric_Nutritional_Risk_Index_Is_a_Simple_Predictor_of_Mortality_in_Chronic_Hemodialysis_Patients_ L2 - https://www.karger.com?DOI=10.1159/000381798 DB - PRIME DP - Unbound Medicine ER -