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. 2020 Apr;50(4):470-476.
doi: 10.1111/imj.14680.

Geriatric nutritional risk index is associated with mortality in peritoneal dialysis patients

Mian Ren  1 , Qilin Sheng  1 , Xishao Xie  1 , Xiaohui Zhang  1 , Fei Han  1 , Jianghua Chen  1
Affiliations

Geriatric nutritional risk index is associated with mortality in peritoneal dialysis patients

Mian Ren et al. Intern Med J. 2020 Apr.

Abstract

Background: Malnutrition is one of the most common complications among dialysis patients. The Geriatric Nutritional Risk Index (GNRI) is rarely used in dialysis patients, especially peritoneal dialysis (PD).

Aim: To use the GNRI to evaluate the initial nutritional state of PD patients and to examine the association between the GNRI and mortality in chronic PD patients.

Methods: We retrospectively examined the medical records at our centre to identify all adults (≥18 years) who had undergone PD for over 3 months before recruitment from January 2005 to December 2017. The correlation between the GNRI and mortality was examined by Kaplan-Meier and Cox proportional hazards analyses.

Results: A total of 1804 patients was enrolled in the study. Significant correlations were noted between the initial GNRI and Charlson index, uric acid, blood calcium, potassium, triglycerides, low-density lipoprotein cholesterol, haemoglobin and so on. Multivariate Cox proportional hazards analyses demonstrated that the GNRI was associated with all-cause mortality (hazard ratio = 0.96, P < 0.001, 95% confidence interval: 0.95-0.98) after adjustment. Compared with the lowest GNRI group, all-cause mortality decreased significantly for each level of GNRI after adjusting for various influencing factors, and the mortality risk of the highest GNRI grade decreased by 66%. The Kaplan-Meier analysis survival rate was significantly different among the four groups in terms of all-cause mortality and cardiovascular and cerebrovascular mortality (log-rank test, P < 0.05).

Conclusions: These results demonstrated that the GNRI is significantly associated with mortality and can be a simple, clinically useful marker for the assessment of nutritional status in PD patients.

Keywords: geriatric nutritional risk index; mortality; nutritional assessment; peritoneal dialysis.

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