Relationship between Geriatric Nutritional Risk Index and total lymphocyte count and mortality of hemodialysis patients

Abstract

We examined the relationships between Geriatric Nutritional Risk Index (GNRI), total lymphocyte count (TLC), and mortality in hemodialysis (HD) patients. We examined GNRI and TLC in 120 maintenance HD patients and followed these patients for 120 months. Predictors of all-cause death were examined using life table analysis and the Cox proportional hazards model. TLC marginally correlated with GNRI (r = 0.176; p = 0.090) and significantly with phosphorus levels (r = 0.206; p = 0.026). Life table analysis revealed that subjects with a GNRI < 90 (n = 19) had lower survival rates than did those with a GNRI ≥ 90 (n = 101; Wilcoxon's test, p = 0.048), but subjects with a TLC < 1500/mm(3) (n = 76) had similar survival rates compared with subjects with a TLC ≥ 1500/mm(3) (n = 44; Wilcoxon's test, p = 0.500). Multivariate Cox proportional hazards analyses demonstrated that GNRI is a significant predictor of mortality (hazard ratio 9.315, 95% confidence interval 1.161-74.753, p = 0.036), after adjusting for age, sex, presence of type 2 diabetes mellitus, Kt/V, normalized protein catabolic rate, hematocrit, phosphorus, systolic blood pressure and TLC. Our findings suggest the TLC may be used as a simple nutritional tool, but may not be a predictor of mortality in HD patients. These findings require confirmation by further studies.

Anastomotic complications after laparoscopic total gastrectomy with esophagojejunostomy constructed by circular stapler (OrVil™) versus linear stapler (overlap method)

“…There was no significant difference in patient characteristics or hematological variables including nutritional variables (total protein, serum albumin and lymphocyte count which sometimes used as a nutrition index [15,16]) between group C and group L. Pathological stage had not significant difference between two groups ( Table 2).…”

“…Shigenori Homma, Dr. Masahiro Takahashi, and Dr. Akinobu Taketomi have no conflicts of 16 interest or financial ties to disclose. b.…”

Lower serum fibroblast growth factor‐23 levels may suggest malnutrition in maintenance haemodialysis patients

“…It is reported that the GNRI is a predictor of mortality in haemodialysis patients. 20 The mean GNRI values of the lowest and second lowest FGF-23 quartiles were <91.2, a level which is generally considered to be indicative of a requirement for nutritional support and to be a risk factor for sarcopenia and earlier mortality. 15 We consider that lower FGF-23 levels are significantly associated with malnutrition.…”

“…The patients in the lowest FGF‐23 quartile displayed the highest age, the shortest dialysis vintage, the lowest dosages of active vitamin D and phosphate binders, and the lowest BMI, nPNA, nPCR, GNRI, serum albumin, serum creatinine, serum phosphate, Ca, Ca × P product, and serum iPTH values among the FGF‐23 quartiles. It is reported that the GNRI is a predictor of mortality in haemodialysis patients . The mean GNRI values of the lowest and second lowest FGF‐23 quartiles were <91.2, a level which is generally considered to be indicative of a requirement for nutritional support and to be a risk factor for sarcopenia and earlier mortality .…”

Relationships of Total Lymphocyte Count and Subpopulation Lymphocyte Counts with the Nutritional Status in Patients Undergoing Hemodialysis/Peritoneal Dialysis

“…15 In ad dition, TLC has been used as a measure of visceral This deserves further investigation in large-scale, prospective, long-term studies.…”