Geriatric Nutritional Risk Index as a Prognostic Factor in Peritoneal Dialysis Patients

Abstract

♦ Background: The Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce. ♦ Methods: We reviewed the medical records at Yeungnam University Hospital in Korea to identify all adults (>18 years) who received PD; 486 patients were enrolled in the study. ♦ Results: The initial low, middle, and high GNRI tertiles included 162, 166, and 158 patients respectively. Significant correlations were noted between the initial GNRI and body mass index, creatinine, albumin, arm circumference, fat mass index, and comorbidities. The cut-off value for the time-averaged GNRI over 1 year was 96.4, and the sensitivity and specificity for a diagnosis of a decline in lean mass were 77.1% and 40.0% respectively. A multivariate analysis adjusted for age, risk according to the Davies comorbidity index, and C-reactive protein showed that an low initial GNRI tertile was associated with mortality in PD patients. ♦ Conclusions: The GNRI is a simple method for predicting nutrition status and clinical outcome in PD patients.

Is the Geriatric Nutritional Risk Index a Significant Predictor of Postoperative Complications in Patients with Esophageal Cancer Undergoing Esophagectomy?

“…In older patients with sepsis, a GNRI of 82-87 and a GNRI <82 could independently predict the mortality risk [21]. In peritoneal dialysis patients, a low initial GNRI tertile was associated with mortality [10]. In our present study, the multivariate analysis demonstrated that the GNRI was an independent significant factor predicting postoperative respiratory complications.…”

“…However, despite its frequent use, albuminemia remains an unreliable indicator of the nutritional status, because it may be more closely related to inflammation or the hydration status than to malnutrition. Recently, the Geriatric Nutritional Risk Index (GNRI), a new prognostic index of nutritional status-related complications, has been proposed for the evaluation of at-risk elderly patients [1,2,3,4,5,6] and hemodialysis patients [7,8,9,10,11,12], and it was revealed to be a predictor of morbidity and mortality and for the possible use in grading the patient's nutritional status. The relationship between the GNRI and the morbidity of patients with gastrointestinal cancer has not yet been reported.…”

Association of Geriatric Nutritional Risk Index with Mortality in Hemodialysis Patients: A Meta-Analysis of Cohort Studies

“…Moreover, they also found that lowmiddle GNRI have the highest mortality rate (HR 4.28, 95%CI 2.66 to 6.88) if patients with low phosphorus level [38]. The association between GNRI and mortality has been further validated from PD and nondialysis CKD patients [39,40]. Based on all the available studies, our meta-analysis further confirmed the results that high GNRI score can decrease the risk of all-cause mortality, while low GNRI was associated with high mortality for dialysis patients.…”

Poor nutritional status is associated with low physical activity in patients undergoing peritoneal dialysis

“…Some studies showed the usefulness of the GNRI as a new marker for malnutrition screening in dialysis patients [12,13]. A few reports have also shown that in PD patients, the GNRI is associated with nutritional status and is an independent risk factor for mortality [14,15]. Therefore, we believe that any differences in GNRI status in relation to PA in PD patients also require elucidation.…”