Yuran Zhang1, Zheng Zhang1, Qing Yu1, Weijie Yuan2. 1. Department of Nephrology, Shanghai Jiaotong University, Shanghai First People's Hospital , Shanghai 200080, China. 2. Department of Nephrology, Shanghai Jiaotong University, Shanghai First People's Hospital , Shanghai 200080, China; Email: ywj4169@163.com.
Abstract
OBJECTIVE: To explore the reliability of the Geriatric Nutritional Risk Index (GNRI) as a mortality predictor in elderly patients undergoing hemodialysis (HD). METHODS: A total of 125 maintenance HD patients aged >60 years old who had received dialysis for over 6 months before entry was retrospectively examined. The values of GNRI were calculated, and death was taken as the end point. The patients were divided into 4 groups according to the quartiles of GNRI values. All-cause and cardiovascular mortality were calculated using Kaplan-Meier and cox proportional-hazards analyses, and ROC curve was adopted for analyzing the predicting value of GNRI on mortality. RESULTS: The GNRI of the four groups were ≤92.06, 92.07-96.15, 96.16-101.25, ≥101.26, respectively. Kaplan-Meier survival rate was significantly different among 4 groups for all-cause and cardiovascular mortality. Cox regression model analysis demonstrated that the GNRI was a predictor for all cause (HR=0.940, P=0.001, 95%CI: 0.907-0.974) and cardiovascular mortality (HR=0.906, P<0.001, 95%CI: 0.863-0.951). The area under ROC curve was 0.667 (P=0.001) for all-cause mortality and 0.717 (P=0.001) for cardiovascular mortality. CONCLUSION: The GNRI is a reliable predictor for all-cause mortality in maintainance HD patients, but more multi-center studies with larger samples are still needed.
OBJECTIVE: To explore the reliability of the Geriatric Nutritional Risk Index (GNRI) as a mortality predictor in elderly patients undergoing hemodialysis (HD). METHODS: A total of 125 maintenance HDpatients aged >60 years old who had received dialysis for over 6 months before entry was retrospectively examined. The values of GNRI were calculated, and death was taken as the end point. The patients were divided into 4 groups according to the quartiles of GNRI values. All-cause and cardiovascular mortality were calculated using Kaplan-Meier and cox proportional-hazards analyses, and ROC curve was adopted for analyzing the predicting value of GNRI on mortality. RESULTS: The GNRI of the four groups were ≤92.06, 92.07-96.15, 96.16-101.25, ≥101.26, respectively. Kaplan-Meier survival rate was significantly different among 4 groups for all-cause and cardiovascular mortality. Cox regression model analysis demonstrated that the GNRI was a predictor for all cause (HR=0.940, P=0.001, 95%CI: 0.907-0.974) and cardiovascular mortality (HR=0.906, P<0.001, 95%CI: 0.863-0.951). The area under ROC curve was 0.667 (P=0.001) for all-cause mortality and 0.717 (P=0.001) for cardiovascular mortality. CONCLUSION: The GNRI is a reliable predictor for all-cause mortality in maintainance HDpatients, but more multi-center studies with larger samples are still needed.
Authors: Wei-Ti Su; Shao-Chun Wu; Chun-Ying Huang; Sheng-En Chou; Ching-Hua Tsai; Chi Li; Shiun-Yuan Hsu; Ching-Hua Hsieh Journal: Int J Environ Res Public Health Date: 2020-11-30 Impact factor: 3.390