Geriatric Nutritional Risk Index Is a Simple Predictor of Mortality in Chronic Hemodialysis Patients

2015 ◽  
Vol 39 (4) ◽  
pp. 281-287 ◽  
Author(s):  
Mizuki Komatsu ◽  
Masayuki Okazaki ◽  
Ken Tsuchiya ◽  
Hiroshi Kawaguchi ◽  
Kosaku Nitta
Keyword(s):  
Proportional Hazards ◽  
Risk Index ◽  
Cox Proportional Hazards ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Kaplan Meier ◽  
Nutritional Risk Index ◽  
All Cause Mortality ◽  
Overall Mortality

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.

scholarly journals Lower Geriatric Nutritional Risk Index (GNRI) Is Associated with Higher Risk of Fractures in Patients Undergoing Hemodialysis

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2847
Author(s):  
Maria Yoshida ◽  
Ayumu Nakashima ◽  
Shigehiro Doi ◽  
Kazuya Maeda ◽  
Naoki Ishiuchi ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Bone Fractures ◽  
Risk Index ◽  
Serum Levels ◽  
Cox Proportional Hazards ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Kaplan Meier ◽  
Cox Proportional Hazards Models ◽  
Nutritional Risk Index

Background: Although malnutrition and bone fracture are both major complications in patients undergoing hemodialysis, their association has not been clarified. The aim of our study was to clarify the association between the geriatric nutritional risk index (GNRI), an indicator of nutritional status, and the incidence of bone fractures in patients undergoing hemodialysis. Methods: We included 1342 registered patients undergoing hemodialysis and performed a post hoc analysis. We divided patients into the high GNRI group (≥92), considered to have a low risk of malnutrition, and the low GNRI group (<92), considered to have a high risk of malnutrition. Fracture-free survival in the low and high GNRI groups was evaluated by the Kaplan–Meier method. Cox proportional hazards models were used to identify the risk factors for fractures requiring hospitalization. All results were stratified by sex. Results: New bone fractures developed in 108 (8.0%) patients in 5 years of follow-up. Bone fractures occurred more frequently in the low GNRI group compared with the high GNRI group (HR: 3.51, 95% CI: 1.91–6.42, p < 0.01 in males; HR: 2.47, 95% CI: 1.52–4.03, p < 0.01 in females). A low GNRI was significantly associated with an increased incidence of bone fractures, even after adjustment for covariates. However, the serum levels of calcium, phosphate, parathyroid hormone, and alkaline phosphatase were not associated with the incidence of bone fractures. Conclusions: A low GNRI is an independent risk factor for bone fractures in patients undergoing hemodialysis. Early intervention for the low GNRI group may be important in preventing the occurrence of fractures.

Geriatric nutritional risk index (GNRI) predicts long-term survival and limb events in patients with peripheral artery disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Horiguchi ◽  
H Yamagishi ◽  
K Unno ◽  
T Takamura ◽  
K Tone ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Risk Index ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Peripheral Artery ◽  
Free Survival ◽  
Kaplan Meier ◽  
Nutritional Risk Index ◽  
Artery Disease

Abstract Background Geriatric nutritional risk index (GNRI) was developed as a “nutrition-related” risk index and was reported in different populations as associated with the risk of all-cause and cardiovascular morbidity and mortality. Purpose The purpose of this study was to assess the associations of GNRI with mortality and amputation free survival in patients with peripheral artery disease (PAD). Methods From January 2011 to June 2016, 295 consecutive patients (73.3±9.2 years; 75.6% male) with PAD undergoing endovascular treatment (EVT) in our hospital were retrospectively examined. The GNRI on admission was calculated as follows: 14.89 × serum albumin (g/dl) + 41.7 × body mass index (BMI)/22. Characteristics and mortality were compared between 2 groups: low GNRI (&lt;92, n=110) with moderate or severe nutritional risk; and high GNRI (≥92, n=185) with no or low nutritional risk. Results The median follow up period was 39.4±26.4months. There were 85 deaths (28.8%) and 13 major amputation (4.4%) during the follow-up. Patients in the low-GNRI group were more often higher age, non-ambulatory state, hemodialysis and critical limb ischemia. BMI, serum hemoglobin, albumin, low-density lipoprotein were significantly lower, whereas serum C-reactive protein was significantly higher in the low-GNRI group than the high-GNRI group (P&lt;0.05, respectively). Kaplan–Meier analysis revealed that patients in the low-GNRI group had a significantly lower amputation free survival, compared to those in the high-GNRI group (log-rank test, P&lt;0.001). Conclusion The low GNRI is associated with an increased risk of mortality and limb events in patients with PAD. Amputation-free survival (Kaplan-Meier) Funding Acknowledgement Type of funding source: None

scholarly journals The Significance of Follow-Up Serum Uric Acid Levels in Predicting All-Cause Mortality and Cardiovascular Mortality in Peritoneal Dialysis Patients

2021 ◽  
Author(s):  
Pingping Ren ◽  
Qilong Zhang ◽  
Yixuan Pan ◽  
Yi Liu ◽  
Chenglin Li ◽  
...  
Keyword(s):  
Uric Acid ◽  
Peritoneal Dialysis ◽  
Serum Uric Acid ◽  
Cardiovascular Mortality ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Kaplan Meier ◽  
Significant Difference ◽  
All Cause Mortality

Abstract Background: Studies on the correlation between serum uric acid (SUA) and all-cause mortality in peritoneal dialysis (PD) patients were mainly based on the results of baseline SUA. We aimed to analyze the change of SUA level post PD, and the correlation between follow-up SUA and prognosis in PD patients. Methods: All patients who received PD catheterization and maintaining PD in our center from March 2, 2001 to March 8, 2017 were screened. Kaplan-Meier and Cox proportional-hazards regression models were used to analyze the effect of SUA levels on the risks of death. We graded SUA levels at baseline, 6 months, 12 months, 18 months and 24 months post PD by mean of SUA plus or minus a standard deviation as cut-off values, and compared all-cause and cardiovascular mortality among patients with different SUA grades. Results: A total of 1402 patients were included, 763 males (54.42%) and 639 females (45.58%). Their average age at PD start was 49.50±14.20 years. The SUA levels were 7.97±1.79mg/dl at baseline, 7.12±1.48mg/dl at 6 months, 7.05±1.33mg/dl at 12 months, 7.01±1.30mg/dl at 18 months, and 6.93±1.26mg/dl at 24 months. During median follow-up time of 31 (18, 49) months, 173 (12.34%) all-cause deaths occurred, including 68 (4.85%) cardiovascular deaths. There were no significant differences on all-cause mortality among groups with graded SUA levels at baseline, 12 months, 18 months and 24 months during follow-up or on cardiovascular mortality among groups with graded SUA levels at baseline, 6 months, 12 months, 18 months and 24 months during follow-up. At 6 months post PD，Kaplan Meier analysis showed there was significant difference on all-cause mortality among graded SUA levels (c2=11.315, P=0.010), and the all-cause mortality was lowest in grade of 5.65mg/dl≤SUA<7.13mg/dl. Conclusion: SUA level decreased during follow up post PD. At 6 months post PD, a grade of 5.65mg/dl≤SUA<7.13mg/dl was appropriate for better patients’ survival.

scholarly journals Prognostic Impact of Change in Nutritional Risk on Mortality and Heart Failure After Transcatheter Aortic Valve Replacement

2021 ◽  
Vol 14 (2) ◽  
Author(s):  
Rocío González Ferreiro ◽  
Diego López Otero ◽  
Leyre Álvarez Rodríguez ◽  
Óscar Otero García ◽  
Marta Pérez Poza ◽  
...  
Keyword(s):  
Heart Failure ◽  
Transcatheter Aortic Valve Replacement ◽  
Risk Index ◽  
Nutritional Risk ◽  
Prognostic Impact ◽  
Geriatric Nutritional Risk Index ◽  
Transcatheter Aortic Valve ◽  
Risk Of Mortality ◽  
Nutritional Risk Index

Background: Limited data are available regarding change in the nutritional status after transcatheter aortic valve replacement (TAVR). This study evaluated the prognostic impact of the change in the geriatric nutritional risk index following TAVR. Methods: TAVR patients were analyzed in a prospective and observational study. To analyze the change in nutritional status, geriatric nutritional risk index of the patients was calculated on the day of TAVR and at 3-month follow-up. The impact of the change in nutritional risk index after TAVR on all-cause mortality, heart failure hospitalization (HF-h), and the composite of all-cause death and HF hospitalization was analyzed using the Cox Proportional Hazards model. Results: Four hundred thirty-three patients were included. After TAVR, 68.4% (n=182) patients with baseline nutritional risk improved compared with 31.6% (n=84) who remained at nutritional risk. The change from no-nutritional risk to nutritional risk after TAVR occurred in 15.0% (n=25), while 85.0% (n=142) remained without risk of malnutrition. During follow-up, 157 (36.3%) patients died and 172 patients (39.7%) were hospitalized due to HF. Patients who continued to be at nutritional risk had a higher risk of mortality (hazard ratio [HR], 2.10 [95% CI, 1.30–3.39], P =0.002), HF-h (HR, 1.97 [95% CI, 1.26–3.06], P =0.000), and the composite of death and HF-h (HR, 2.0 [95% CI, 1.37–2.91], P <0.001). The change to non-nutritional risk after TAVR significantly impacted mortality (HR, 0.48 [95% CI, 0.30–0.78], P =0.003), HF-h (HR, 0.50 [95% CI, 0.34–0.74], P =0.001), and the composite outcome (HR, 0.44 [95% CI, 0.32–0.62], P <0.001). Conclusions: Remaining at nutritional risk after TAVR confers a poor prognosis and is associated with an increased risk of mortality and HF-h, while the change from risk of malnutrition to non-nutritional risk after TAVR was associated with a halving of the risk of mortality and HF-h. Further studies are needed to identify whether patients at nutritional risk would benefit from nutritional intervention during processes of care of TAVR programs.

scholarly journals Predictive Value of Geriatric Nutritional Risk Index in Patients With Coronary Artery Disease: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yu Fan ◽  
Lian He ◽  
Yongjing Zhou ◽  
Changfeng Man
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Risk Index ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Nutritional Risk Index ◽  
All Cause Mortality ◽  
Artery Disease

Background: Low Geriatric Nutritional Risk Index has been identified as an index of impaired nutritional state. The objective of the meta-analysis was to assess the association of the Geriatric Nutritional Risk Index (GNRI) with adverse outcomes in patients with coronary artery disease (CAD).Methods: Relevant studies were identified by comprehensively searching PubMed and Embase databases in May 2021. Studies assessing the association of GNRI with all-cause mortality or major adverse cardiovascular events (MACEs) in patients with CAD were included. The predictive value of GNRI was summarized by pooling multivariable adjusted risk ratios (RR) with 95% confidence intervals (CI) per GNRI point decrease or the lowest vs. the highest GNRI group.Results: A total of eight studies involving 9277 patients with CAD were analyzed. Meta-analysis showed that the lowest GNRI was associated with a higher risk of all-cause mortality (RR 2.10; 95% CI 1.68–2.63) and MACEs (RR 2.84; 95% CI 1.56–5.16), respectively. Furthermore, per point decrease in GNRI was associated with 8 and 10% additional risk of all-cause mortality and MACEs. Subgroup analysis indicated that the value of low GNRI in predicting all-cause mortality was not affected by subtype of patients or follow-up duration.Conclusion: Low GNRI score at baseline was associated with a higher risk of all-cause mortality and cardiovascular events in patients with CAD. The nutritional state estimated by the GNRI score could provide important predictive information in patients with CAD.

scholarly journals The Preoperative Geriatric Nutritional Risk Index (GNRI) is an Independent Prognostic Factor in Patients Underwent Curative Resection for Colorectal Cancer.

2021 ◽  
Author(s):  
Tamuro Hayama ◽  
Yojiro Hashiguchi ◽  
Tsuyoshi Ozawa ◽  
Makoto Watanabe ◽  
Yoshihisa Fukushima ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Risk Index ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Curative Surgery ◽  
Kaplan Meier ◽  
Nutritional Risk Index ◽  
Multivariable Analyses ◽  
Colorectal Cancer Patients

Abstract Purpose: T The world is becoming longer-lived, and the number of elderly colorectal cancer patients is increasing. It is very important to identify simple and inexpensive postoperative predictors in elderly colorectal cancer patients. The geriatric nutritional risk index (GNRI) is a marker of systemic nutrition and is associated with poor survival in various kinds of cancers. A few reports have investigated recurrence factors using preoperative GNRI with CRC patients. This study aimed to investigate whether preoperative GNRI is associated with recurrence-free survival (RFS) and overall survival (OS) in elderly patients with CRC.Methods: This study retrospectively enrolled 259 patients with StageⅠ-Ⅲ CRC who were more than 65 years old and underwent curative surgery at a single institution in 2012–2017. We classified them into low GNRI (RFS: ≤90.5, OS ≤101.1) group and high GNRI (RFS:>90.5, OS >101.1) group.Results: Multivariable analyses showed low GNRI group was an independent risk factor for 3-year RFS (P = 0.006) and OS (P = 0.001) in the patients with CRC. Kaplan-Meier analysis showed 3-year RFS and 3-year OS were significantly worse in the low GNRI group than in high GNRI group (p = 0.001, 0.0037).Conclusion: A low-preoperative GNRI was significantly associated with a poor prognosis in elderly CRC patients.

scholarly journals Prognostic impact of malnutrition assessed using geriatric nutritional risk index in patients aged ⩾80 years with heart failure

2019 ◽  
Vol 19 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Tomohiro Nakamura ◽  
Mitsunari Matsumoto ◽  
Yumiko Haraguchi ◽  
Takeshi Ishida ◽  
Shin-ichi Momomura
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
Risk Index ◽  
Cox Proportional Hazards ◽  
Nutritional Risk ◽  
Prognostic Impact ◽  
Geriatric Nutritional Risk Index ◽  
Index Group ◽  
Nutritional Risk Index ◽  
The Mean

Aims: Malnutrition in elderly patients is one of the important issues in an aging society. We aimed to investigate the prevalence and prognostic impact of malnutrition assessed using the geriatric nutritional risk index in very elderly patients hospitalized owing to heart failure. Methods: We enrolled 213 consecutive patients aged ⩾80 years who were hospitalized with heart failure. The mean age was 87.2 ± 4.9 years, and 43.7% of them were male. The nutritional status on admission was evaluated using the geriatric nutritional risk index, which was calculated as follows: 14.89 × serum albumin (g/dL) + 41.7 × body mass index/22. The patients were divided into two groups, a low geriatric nutritional risk index group (<92) with malnutrition risk and a high geriatric nutritional risk index group (⩾92) without malnutrition risk. Results: The mean geriatric nutritional risk index of all patients was 90.7 ± 10.6, and 108 patients (50.7%) had low geriatric nutritional risk index. During the 540-day follow-up, the all-cause mortality was significantly higher in the low geriatric nutritional risk index group than in the high geriatric nutritional risk index group (35.7% vs. 12.9%, p < 0.001). The Cox proportional-hazards regression analysis revealed that low geriatric nutritional risk index was an independent predictor of mortality (hazard ratio, 2.28; 95% confidence interval, 1.15–4.49; p = 0.02). Conclusions: Low geriatric nutritional risk index on admission was common and was associated with poor prognosis in patients aged ⩾80 years who were hospitalized owing to heart failure.

Claudication, in contrast to angina pectoris, independently predicts mortality risk in the general population

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 105-113 ◽  
Author(s):  
G. Kieback ◽  
Lorbeer ◽  
Wallaschofski ◽  
Ittermann ◽  
Völzke ◽  
...  
Keyword(s):  
Angina Pectoris ◽  
Mortality Rate ◽  
Cardiovascular Mortality ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Kaplan Meier ◽  
All Cause Mortality ◽  
Study Population

Background: The aim of our analyses was to investigate whether claudication and angina pectoris, each defined and based on the answer to a single question, are predictive of future mortality. Probands and methods: The study population consisted of 3995 subjects selected from the population-based Study of Health In Pomerania (SHIP). Kaplan-Meier analysis and multivariable Cox proportional hazards regression analysis were used to analyze the association of angina pectoris and claudication with all-cause and cardiovascular mortality adjusted for major cardiovascular risk factors. Results: At baseline, 417 individuals had symptoms of angina pectoris, and 323 had symptoms of claudication. During a median follow-up of 8.5 years, 277 individuals died. Individuals with claudication had a higher fully-adjusted all-cause mortality rate (Hazard Ratio (HR) 1.79; 95 % CI 1.34, 2.39, p < 0.001) and a higher sex- and age-adjusted cardiovascular mortality rate (HR 1.76; 95 % CI 1.03, 2.99, p = 0.038) compared to subjects without claudication. In contrast, subjects with angina pectoris had neither an elevated fully-adjusted all-cause mortality rate (HR 1.15; 95 % CI 0.82, 1.61, p = 0.413) nor sex- and age-adjusted cardiovascular mortality rate (HR 0.71; 95 % CI 0.34, 1.48, p = 0.363) compared to those without this symptom. Conclusions: Claudication, in contrast to angina pectoris, is a strong, independent predictor of all-cause mortality.

Sign in / Sign up

Export Citation Format

Share Document