Utility of Geriatric Nutritional Risk Index in Patients with Chronic Kidney Disease: A Mini-Review

Nakagawa, Naoki; Maruyama, Kouichi; Hasebe, Naoyuki

doi:10.3390/nu13113688

Cited by 46 publications

(34 citation statements)

References 57 publications

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“…The GNRI, which considers both serum albumin levels and body weight, is also used to assess the nutritional status of patients and shows the predictive value for adverse outcomes ( 2 , 3 ). The unique advantage of the GNRI is that the ratio of body weight to ideal body weight allows for a better reflection of the extent to which malnourished participants deviate from normal BMI, which can help assess short-term nutritional status.…”

Section: Discussionmentioning

confidence: 99%

Association of Four Nutritional Scores With All-Cause and Cardiovascular Mortality in the General Population

et al. 2022

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Background and AimsMalnutrition is a well known risk factor for adverse outcomes in patients with cancer, cardiovascular disease (CVD) and chronic kidney disease, but epidemiological evidence on its relationship with the long-term risk of all-cause mortality and cardiovascular death is limited.MethodsA total of 20,116 adults from the United States National Health and Nutrition Examination Survey 2007–2014 were enrolled. The Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT) score, and Triglycerides (TG) × Total Cholesterol (TC) × Body Weight (BW) Index (TCBI) were calculated at baseline. Cox regression and the Kaplan–Meier analysis were conducted when participants were divided into three groups according to the tertiles of objective nutritional scores. Restricted cubic spline was performed to further explore the shape of the relationship between all-cause mortality, cardiovascular death, and nutritional scores. In addition, the area under the curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were conducted to assess which nutritional scores have the greatest predictive value for all-cause death and cardiovascular death in the general population.ResultsThe cumulative incidence of all-cause death and cardiovascular death was significantly higher in participants with a higher CONUT score, lower GNRI, and lower PNI. TCBI showed the worst performance on grading and risk assessment. After adjusting confounding factors, the lowest PNI and GNRI tertile and highest COUNT score were independently and significantly associated with increased risk of all-cause death (all P < 0.01) and cardiovascular death (all P < 0.05) analyzed by a multivariate Cox regression model. An L-shaped association between the HR (hazard ratio) of all-cause mortality and nutritional scores (GNRI, PNI and TCBI) was observed in the overall populations. In addition, the PNI had the highest predictive value for all-cause mortality [AUC: 0.684, 95% confidence interval (CI): 0.667–0.701] and cardiovascular death (AUC: 0.710, 95% CI: 0.672–0.749) in the general population compared with other nutritional scores.ConclusionThe poorer the nutritional status of the general population, the higher the all-cause mortality and cardiovascular mortality. The PNI score may provide more useful predictive values than other nutritional scores.

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Section: Discussionmentioning

confidence: 99%

Association of Four Nutritional Scores With All-Cause and Cardiovascular Mortality in the General Population

et al. 2022

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“…Recently, various nutritional indexes [such as GNRI and skeletal muscle mass index (23)] have emerged in evaluating the nutritional status of patients with EC, which have better manifestation than traditional NRI. GNRI is a nutritional indicator combined with both serum albumin, present, and ideal body weight, which could accurately reflect the nutritional level of patients and provide more comprehensive nutritional support treatment, thereby improving the accuracy of predicting the prognosis of patients with EC (24). The index has been wildly applied to evaluate the malnutrition status and severity degree of postoperative complications of hospitalized adults.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Geriatric Nutritional Risk Index in Esophageal Carcinoma: A Systematic Review and Meta-Analysis

Zhou

Fang

et al. 2022

Front. Nutr.

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Esophageal cancer (EC) is one of the most common cancers worldwide. Malnutrition often leads to poor prognosis of patients with EC. Geriatric nutritional risk index (GNRI) was reported as an objective nutrition-related risk index. We intend to comprehensively review evidence of GNRI in predicting EC prognosis. To explore the influence of GNRI on the long-term survival outcome of patients with EC, a meta-analysis was needed. We searched the Web of Science, Medline, Embase, and the Cochrane Library databases. The association between prognosis of patients with EC and GNRI was evaluated by pooling hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs). The fixed model or random model method was chosen according to the heterogeneity among the studies. Totally, 11 studies with 1785 patients who met the inclusion criteria were eventually included in our meta-analysis. Comparing the lower level GNRI group and the higher level GNRI group, the pooled results showed that lower GNRI had a negative impact on overall survival (OS) (HR: 1.75, 95% CI: 1.45–2.10, P < 0.01) and cancer-specific survival (CSS) (HR: 1.77, 95% CI: 1.19–2.62, P < 0.01), indicating that lower GNRI significantly predicted poor OS. In conclusion, lower GNRI could predict the poor prognosis of patients with EC. Meanwhile, more well-designed randomized controlled trials (RCTs) are needed to confirm the findings.

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“…A score under 82 represents a high risk of complications, between 82 and 92 points to a moderate risk, and above 92, a low risk. In geriatric patients, this index is associated with complications and outcomes in different types of patients: postoperative patients, patients with heart failure, cancer, and chronic kidney disease, among others [60][61][62][63][64]. Together with the MNA, it is the most widely used index in elderly hospitalized patients [65], and is a useful clinical predictor of a poor six month outcome, although its accuracy of prediction is low [27].…”

Section: Geriatric Nutritional Risk Index (Gnri)mentioning

confidence: 99%

Malnutrition Screening and Assessment

et al. 2022

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Malnutrition is a serious problem with a negative impact on the quality of life and the evolution of patients, contributing to an increase in morbidity, length of hospital stay, mortality, and health spending. Early identification is fundamental to implement the necessary therapeutic actions, involving adequate nutritional support to prevent or reverse malnutrition. This review presents two complementary methods of fighting malnutrition: nutritional screening and nutritional assessment. Nutritional risk screening is conducted using simple, quick-to-perform tools, and is the first line of action in detecting at-risk patients. It should be implemented systematically and periodically on admission to hospital or residential care, as well as on an outpatient basis for patients with chronic conditions. Once patients with a nutritional risk are detected, they should undergo a more detailed nutritional assessment to identify and quantify the type and degree of malnutrition. This should include health history and clinical examination, dietary history, anthropometric measurements, evaluation of the degree of aggression determined by the disease, functional assessment, and, whenever possible, some method of measuring body composition.

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Utility of Geriatric Nutritional Risk Index in Patients with Chronic Kidney Disease: A Mini-Review

Cited by 46 publications

References 57 publications

Association of Four Nutritional Scores With All-Cause and Cardiovascular Mortality in the General Population

Association of Four Nutritional Scores With All-Cause and Cardiovascular Mortality in the General Population

Prognostic Value of Geriatric Nutritional Risk Index in Esophageal Carcinoma: A Systematic Review and Meta-Analysis

Malnutrition Screening and Assessment

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