Prognostic significance of malnutrition risk in elderly patients with acute kidney injury in the intensive care unit

Abstract

Background Malnutrition is common in critically ill patients, but nutrition status in critically ill patients with acute kidney injury (AKI) has been poorly studied. Our study aimed to investigate the relationship between malnutrition risk and the occurrence and prognosis of AKI in elderly patients in the intensive care unit (ICU). Methods Data were extracted from the Beijing Acute Kidney Injury Trial (BAKIT). A total of 1873 elderly patients were included and compared according to the clinical characteristics of AKI and non-AKI groups, and those of survivors and non-survivors of AKI in this study. Receiver operating characteristic (ROC) curves were used to analyse the predictive value of the modified Nutrition Risk in Critically Ill (mNUTRIC) score for the occurrence and 28-day prognosis of AKI. Multivariate Cox regression analysis was used to evaluate the effect of the mNUTRIC score on the 28-day mortality in AKI patients. Results Compared with the non-AKI group, AKI patients had higher mNUTRIC scores, and non-survivors had higher mNUTRIC scores than survivors in AKI population. Moreover, multivariate Cox regression showed that 28-day mortality in AKI patients increased by 9.8% (95% CI, 1.018-1.184) for every point increase in the mNUTRIC score, and the mNUTRIC score had good predictive ability for the occurrence of AKI and 28-day mortality in AKI patients. The mortality of AKI patients with mNUTRIC > 4 was significantly increased. Conclusions The elderly patients are at high risk of malnutrition, which affects the occurrence and prognosis of AKI. Adequate attention should be given to the nutritional status of elderly patients. Trial registration This study was registered at www.chictr.org.cn (registration number Chi CTR-ONC-11001875) on 14 December 2011.

The prognostic effects of the geriatric nutritional risk index on elderly acute kidney injury patients in intensive care units

“…Our analysis exhibited that decreased GNRI was remarkably associated with elevated mortality risk and prolonged stay length. This was in agreement with the results of the previously published studies: Malnourished AKI patients revealed lower survival rates (21)(22)(23). The BMI and ALB, components of GNRI, demonstrated a strong correlation with the mortality of critically ill AKI patients (24,25).…”

What Promotes Acute Kidney Injury in Patients with Myocardial Infarction and Multivessel Coronary Artery Disease—Contrast Media, Hydration Status or Something Else?

“…Based on the available data, it appears that malnutrition status may be a risk factor for AKI in severely ill patients, regardless of their use of CM. Among elderly patients hospitalized in the intensive care unit, the group diagnosed with AKI had a higher risk of malnutrition as assessed by modified Nutrition Risk in Critically Ill (mNUTRIC) compared to the group without AKI [ 57 ]. Further studies may reveal whether the risk of AKI in patients with malnutrition and MVCAD differs depending on the revascularization strategy adopted and the amount of CM used.…”

Association of Malnutrition with Risk of Acute Kidney Injury: A Systematic Review and Meta-Analysis

“…The population of the original studies was mainly from China [ 10 – 12 , 17 – 21 , 23 , 25 , 28 ]; three were from Turkey [ 16 , 22 , 24 , 26 , 27 ], and one was from America [ 15 ]. Among the 17 studies, 11 studies included patients undergoing coronary angiography (CAG) or percutaneous coronary angiography [ 11 , 12 , 16 , 17 , 19 , 21 , 23 – 26 , 28 ], two included patients undergoing coronary artery bypass [ 22 , 27 ], one was related to pediatric severe sepsis [ 15 ], and three included patients with other diseases [ 10 , 18 , 20 ]. Malnutrition was mainly assessed using the CONUT score, geriatric nutritional risk index, Modified Nutrition Risk in Critically Ill Patients score, PNI, and NRS-2002.…”