A Low Geriatric Nutrition Risk Index Is Associated with Progression to Dialysis in Patients with Chronic Kidney Disease
Evaluating nutritional status is crucial to detecting malnutrition in patients with chronic kidney disease (CKD). The Geriatric Nutritional Risk Index (GNRI) has been associated with overall and cardiovascular mortality in the dialysis population. The aim of this study was to evaluate whether the GN...
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doaj-8e9492da19a547a6a2b12a4f79d793f82020-11-24T23:55:28ZengMDPI AGNutrients2072-66432017-11-01911122810.3390/nu9111228nu9111228A Low Geriatric Nutrition Risk Index Is Associated with Progression to Dialysis in Patients with Chronic Kidney DiseaseI-Ching Kuo0Jiun-Chi Huang1Pei-Yu Wu2Szu-Chia Chen3Jer-Ming Chang4Hung-Chun Chen5Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, TaiwanGraduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, TaiwanGraduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, TaiwanGraduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, TaiwanDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, TaiwanEvaluating nutritional status is crucial to detecting malnutrition in patients with chronic kidney disease (CKD). The Geriatric Nutritional Risk Index (GNRI) has been associated with overall and cardiovascular mortality in the dialysis population. The aim of this study was to evaluate whether the GNRI is associated with progression to dialysis in patients with moderate to advanced CKD. We enrolled 496 patients with stage 3–5 CKD who had received echocardiographic examinations, and categorized them according to baseline GNRI values calculated using the serum albumin level and body weight. The renal end-point was defined as the commencement of dialysis. During follow-up (mean, 25.2 ± 12.5 months; range, 3.3–50.1 months), 106 (21.4%) of the patients progressed to dialysis. The GNRI was positively correlated with the left ventricular ejection fraction (LVEF) (r = 0.111, p = 0.014), and negatively correlated with the left ventricular mass index (r = −0.116, p = 0.001), left ventricular hypertrophy (r = −0.095, p = 0.035), and LVEF < 50% (r = −0.138, p = 0.002). In multivariable Cox analysis, a low GNRI, female sex, high systolic blood pressure, high fasting glucose, and low estimated glomerular filtration rate were independently associated with progression to dialysis. A low GNRI was independently associated with progression to dialysis in our study cohort. The GNRI may be useful in predicting the risk of adverse renal outcomes in patients with CKD stages 3–5. Additional studies are needed to explore whether an improvement in GNRI delays CKD progression.https://www.mdpi.com/2072-6643/9/11/1228geriatric nutritional risk index (GNRI)chronic kidney disease (CKD)progression to dialysisechocardiographic parameters |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
I-Ching Kuo Jiun-Chi Huang Pei-Yu Wu Szu-Chia Chen Jer-Ming Chang Hung-Chun Chen |
spellingShingle |
I-Ching Kuo Jiun-Chi Huang Pei-Yu Wu Szu-Chia Chen Jer-Ming Chang Hung-Chun Chen A Low Geriatric Nutrition Risk Index Is Associated with Progression to Dialysis in Patients with Chronic Kidney Disease Nutrients geriatric nutritional risk index (GNRI) chronic kidney disease (CKD) progression to dialysis echocardiographic parameters |
author_facet |
I-Ching Kuo Jiun-Chi Huang Pei-Yu Wu Szu-Chia Chen Jer-Ming Chang Hung-Chun Chen |
author_sort |
I-Ching Kuo |
title |
A Low Geriatric Nutrition Risk Index Is Associated with Progression to Dialysis in Patients with Chronic Kidney Disease |
title_short |
A Low Geriatric Nutrition Risk Index Is Associated with Progression to Dialysis in Patients with Chronic Kidney Disease |
title_full |
A Low Geriatric Nutrition Risk Index Is Associated with Progression to Dialysis in Patients with Chronic Kidney Disease |
title_fullStr |
A Low Geriatric Nutrition Risk Index Is Associated with Progression to Dialysis in Patients with Chronic Kidney Disease |
title_full_unstemmed |
A Low Geriatric Nutrition Risk Index Is Associated with Progression to Dialysis in Patients with Chronic Kidney Disease |
title_sort |
low geriatric nutrition risk index is associated with progression to dialysis in patients with chronic kidney disease |
publisher |
MDPI AG |
series |
Nutrients |
issn |
2072-6643 |
publishDate |
2017-11-01 |
description |
Evaluating nutritional status is crucial to detecting malnutrition in patients with chronic kidney disease (CKD). The Geriatric Nutritional Risk Index (GNRI) has been associated with overall and cardiovascular mortality in the dialysis population. The aim of this study was to evaluate whether the GNRI is associated with progression to dialysis in patients with moderate to advanced CKD. We enrolled 496 patients with stage 3–5 CKD who had received echocardiographic examinations, and categorized them according to baseline GNRI values calculated using the serum albumin level and body weight. The renal end-point was defined as the commencement of dialysis. During follow-up (mean, 25.2 ± 12.5 months; range, 3.3–50.1 months), 106 (21.4%) of the patients progressed to dialysis. The GNRI was positively correlated with the left ventricular ejection fraction (LVEF) (r = 0.111, p = 0.014), and negatively correlated with the left ventricular mass index (r = −0.116, p = 0.001), left ventricular hypertrophy (r = −0.095, p = 0.035), and LVEF < 50% (r = −0.138, p = 0.002). In multivariable Cox analysis, a low GNRI, female sex, high systolic blood pressure, high fasting glucose, and low estimated glomerular filtration rate were independently associated with progression to dialysis. A low GNRI was independently associated with progression to dialysis in our study cohort. The GNRI may be useful in predicting the risk of adverse renal outcomes in patients with CKD stages 3–5. Additional studies are needed to explore whether an improvement in GNRI delays CKD progression. |
topic |
geriatric nutritional risk index (GNRI) chronic kidney disease (CKD) progression to dialysis echocardiographic parameters |
url |
https://www.mdpi.com/2072-6643/9/11/1228 |
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