Geriatric Nutritional Risk Index as a Simple Predictor of Mortality in Maintenance Hemodialysis Patients: A Single Center Study

Abstract

Background: Malnutrition is associated with higher risk of mortality in maintenance hemodialysis (MHD) patients. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. Objectives: The purpose of the present study was to examine the significance of the GNRI as a mortality predictor in MHD patients. Methods: We retrospectively examined the GNRI of 259 MHD patients aged 59.2 ± 12.8 years, and followed up for 36 months. The patients were divided into two groups according to GNRI values of 91.0. Predictors for all-cause mortality were examined using Kaplan-Meier and Cox proportional-hazards analyses. Results: During the follow-up period of 36 months, a total of 76 patients died. Kaplan-Meier survival analysis showed that the subjects with a GNRI < 91 (n = 29) had a lower survival rate than those with a GNRI > 91 (n = 230) (Log-rank test, p < 0.0001). Multivariate Cox proportional-hazards analysis demonstrated that the GNRI was a significant predictor of adjusted all-cause mortality (hazard ratio 0.927; confidence interval 0.870 - 0.984, p = 0.013). Conclusion: The results of the present study demonstrate that the GNRI is a strong predictor of all-cause mortality in MHD patients.