An Invitation of the Combination of the Geriatric Nutritional Risk Index and the Triglyceride to High-Density Lipoprotein Cholesterol Ratio as a Mortality Predictor in Maintenance Hemodialysis Patients — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
An Invitation of the Combination of the Geriatric Nutritional Risk Index and the Triglyceride to High-Density Lipoprotein Cholesterol Ratio as a Mortality Predictor in Maintenance Hemodialysis Patients
Department of Medicine, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan
,
Department of Blood Purification, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan
,
Department of Nephrology, Jyoban Hospital, Fukushima, Japan
,
Department of Nephrology, Jyoban Hospital, Fukushima, Japan
,
Department of Nephrology, Jyoban Hospital, Fukushima, Japan
,
Department of Blood Purification, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan
,
Department of Medicine, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan
1 Department of Medicine, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan
2 Department of Blood Purification, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan
3 Department of Nephrology, Jyoban Hospital, Fukushima, Japan
4 Department of Nephrology, Jyoban Hospital, Fukushima, Japan
5 Department of Nephrology, Jyoban Hospital, Fukushima, Japan
6 Department of Blood Purification, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan
7 Department of Medicine, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan
Background: The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been shown to be a predictor of cardiovascular (CV) outcomes in the general population. Objectives: The aim of this study was to determine whether the combination of GNRI and TG/HDL-C ratio is a predictor of all-cause mortality and CV deaths in maintenance hemodialysis (MHD) patients. Methods: We performed a retrospective, observational cohort study in which we enrolled 341 MHD patients from a single center in Japan who had been followed up for a mean of 48.0 ± 12.7 months. The outcomes were defined as the occurrence of all-cause mortality and CV deaths during the follow-up period. Baseline GNRI and TG/HDL-C ratios were investigated for associations with outcomes by using Cox proportion hazards models adjusted for demographic parameters. Results: Overall, 101 of the subjects had died, of whom 52 died due to CV events during the mean follow-up period of 48.0 ± 12.7 months. The patients were grouped into four categories according to a median GNRI < 95.3 or ≥95.3 and a median TG/HDL-C ratio < 2.09 or ≥2.09. The group with a GNRI ≥ 95.3 and TG/HDL-C ≥ 2.09 had significantly lower overall and CV mortality rate when compared with the other three groups. Conclusion: The combination of GNRI and TG/HDL-C ratio is an easily accessible marker for predicting all-cause mortality and CV deaths in MHD patients.
Yamada, K., Furuya, R., Takita, T., Maruyama, Y., Yamaguchi, Y., Ohkawa, S., et al. (2008) Simplified Nutritional Screening Tools for Patients on Maintenance Hemodialysis. American Journal of Clinical Nutrition, 87, 106-113.
Kobayashi, I., Ishimura, E., Kato, Y., Okuno, S., Yamamoto, T., Yamakawa, T., et al. (2010) Geriatric Nutritional Risk Index, a Simplified Nutritional Screening Index, Is a Significant Predictor of Mortality in Chronic Dialysis Patients. Nephrology Dialysis Transplant, 25, 3361-3365. https://doi.org/10.1093/ndt/gfq211
Park, J.H., Kim, S.B., Shin, H.S., Jung, Y.S. and Rim, H. (2012) Geriatric Nutritional Risk Index May Be a Significant Predictor of Mortality in Korean Hemodialysis Patients: A Single Center Study. Therapeutic Apheresis and Dialysis, 16, 121-126. https://doi.org/10.1111/j.1744-9987.2011.01046.x
Ballantyne, C.M., Olsson, A.G., Cook, T.J., Mercuri, M.F., Pedersen, T.R. and Kjekshus, J. (2001) Influence of Low High-Density Lipoprotein Cholesterol and Elevated Triglyceride on Coronary Heart Disease Events and Response to Simvastatin Therapy in 4S. Circulation, 104, 3046-3051. https://doi.org/10.1161/hc5001.100624
Manninen, V., Tenkanen, L., Koskinen, P., Huttunen, J.K., Manttari, M., Heinonen, O.P., et al. (1992) Joint Effects of Serum Triglyceride and LDL Cholesterol and HDL Cholesterol Concentrations on Coronary Heart Disease Risk in the Helsinki Heart Study. Implications for Treatment. Circulation, 85, 37-45. https://doi.org/10.1161/01.CIR.85.1.37
Frohlich, J. and Dobiasova, M. (2003) Fractional Esterification Rate of Cholesterol and Ratio of Triglycerides to HDL-Cholesterol Are Powerful Predictors of Positive Findings on Coronary Angiography. Clinical Chemistry, 49, 1873-1880. https://doi.org/10.1373/clinchem.2003.022558
McLaughlin, T., Reaven, G., Abbasi, F., Lamendola, C., Saad, M., Waters, D., et al. (2005) Is There a Simple Way to Identify Insulin-Resistant Individuals at Increased Risk of Cardiovascular Disease? American Journal of Cardiology, 96, 399-404. https://doi.org/10.1016/j.amjcard.2005.03.085
Gaziano, J.M., Hennekens, C.H., O’Donnell, C.J., Breslow, J.L. and Buring, J.E. (1997) Fasting Triglycerides, High-Density Lipoprotein, and Risk of Myocardial Infarction. Circulation, 96, 2520-2525. https://doi.org/10.1161/01.CIR.96.8.2520
Jeppesen, J., Hein, H.O., Suadicani, P. and Gymtelberg, F. (2001) Low Triglycerides-High High-Density Lipoprotein Cholesterol and Risk of Ischemic Heart Disease. Archives of Internal Medicine, 161, 361-366. https://doi.org/10.1001/archinte.161.3.361
Barzi, F., Patel, A., Woodward, M., Lawes, C.M., Ohkubo, T., Gu, D., et al. (2005) A Comparison of Lipid Variables as Predictors of Cardiovascular Disease in the Asia Pacific Region. Annals of Epidemiology, 15, 405-413. https://doi.org/10.1016/j.annepidem.2005.01.005
Bittner, V., Johnson, B.D., Zineh, I., Rogers, W.J., Vido, D., Marroquin, O.C., et al. (2009) The Tri-glyceride/High-Density Lipoprotein Cholesterol Ratio Predicts All-Cause Mortality in Women with Suspected Myocardial Ischemia: A Report from the Women’s Ischemia Syndrome Evaluation (WISE). American Heart Journal, 157, 548-555. https://doi.org/10.1016/j.ahj.2008.11.014
Daugirdas, J.T. (1993) Second Generation Logarithmic Estimates of Single-Pool Variable Volume Kt/V: An Analysis of Error. Journal of American Society of Nephrology, 4, 1205-1213.
Shinzato, T., Nakai, S., Fujita, Y., Takai, I., Morita, H., Nakane, K., et al. (1994) Determination of Kt/V and Protein Catabolic Rate Using Pre- and Post-Dialysis Blood Urea Nitrogen Concentrations. Nephron, 67, 280-290. https://doi.org/10.1159/000187980
Examination Committee of Criteria for “Obesity Disease” in Japan and Japan Society for the Study of Obesity (2002) New Criteria for Obesity Disease in Japan. Circulation Journal, 66, 987-992. https://doi.org/10.1253/circj.66.987
Nitta, K. and Tsuchiya, K. (2016) Recent Advances in the Pathophysiology and Management of Protein-Energy Wasting in Chronic Kidney Disease. Renal Replacement Therapy, 2, 4. https://doi.org/10.1186/s41100-016-0015-5
Kalantar-Zadeh, K., Kopple, J.D., Humphreys, M.H. and Block, G. (2004) Comparing Outcome Predictability of Markers of Malnutrition-Inflammation Complex Syndrome in Hemodialysis Patients. Nephrology Dialysis Transplantation, 19, 1507-1519. https://doi.org/10.1093/ndt/gfh143
De Mutsert, R., Grootendorst, D.C., Axelsson, J., Boeschoten, E.W., Krediet, R.T., et al. (2008) Excess Mortality to Interaction between Protein-Energy Wasting, Inflammation and Cardiovascular Disease in Chronic Dialysis Patients. Nephrology Dialysis Transplantation, 23, 2957-2964. https://doi.org/10.1093/ndt/gfn167
Baumeister, S.E., Fischer, B., Doring, A., Koenig, W., Zierer, A., et al. (2011) The Geriatric Nutritional Risk Index Predicts Increased Healthcare Costs and Hospitalization in a Cohort of Community-Dwelling Older Adults: Results from the Monica/Kora Augsburg Cohort Study, 1994-2005. Nutrition, 27, 534-542. https://doi.org/10.1016/j.nut.2010.06.005
Takahashi, H., Ito, Y., Ishii, H., Aoyama, T., Kamoi, D., Kasuga, H., et al. (2014) Geriatric Nutritional Risk Index Accurately Predicts Cardiovascular Mortality in Incident Hemodialysis Patients. Journal of Cardiology, 64, 32-36. https://doi.org/10.1016/j.jjcc.2013.10.018
Komatsu, M., Okazaki, M., Tsuchiya, K., Kawaguchi, H. and Nitta, K. (2015) Geriatric Nutritional Index Is Simple Predictor of Mortality in Chronic Hemodialysis Patients. Blood Purification, 39, 281-287. https://doi.org/10.1159/000381798
Kilpatrick, R.D., McAllister, C.J., Kovesdy, C.P., Derose, S.F., Kopple, J.D. and Kalantar-Zadeh, K. (2007) Association between Serum Lipids and Survival in Hemodialysis Patients and Impact of Race. Journal of American Society of Nephrology, 18, 293-303. https://doi.org/10.1681/ASN.2006070795
Hasegawa, A., Kojima, F., Ueda, M., Tanaka, Y. and Nitta, K. (2016) Triglyceride to High-Density Lipoprotein Cholesterol Ratio Predicts Cardiovascular Events in Maintenance Hemodialysis Patients. Renal Replacement Therapy, 2, 60. https://doi.org/10.1186/s41100-016-0069-4
Chen, H.Y., Tsai, W.C., Chiu, Y.L., Hsu, S.P., Pai, M.E., et al. (2015) Triglyceride to High-Density Lipoprotein Cholesterol Ratio Predicts Cardiovascular Outcomes in Prevalent Dialysis Patients. Medicine (Baltimore), 94, e619. https://doi.org/10.1097/MD.0000000000000619
Carrero, J.J., Stenvinkel, P., Cuppari, L., Ikizler, T.A., Kalantar-Zadeh, K., Kaysen, G., et al. (2013) Etiology of the Protein-Energy Wasting Syndrome in Chronic Kidney Disease: A Consensus Statement from the International Society of Renal Nutrition and Metabolism (ISRNM). Journal of Renal Nutrition, 23, 77-90. https://doi.org/10.1053/j.jrn.2013.01.001
AIM-HIGH Investigators (2011) The Role of Niacin in Raising High-Density Lipoprotein Cholesterol to Reduce Cardiovascular Events in Patients with Atherosclerotic Cardiovascular Disease and Optimally Treated Low-Density Lipoprotein Cholesterol: Baseline Characteristics of Study Participants. The Atherothrombosis Intervention in Metabolic Syndrome with Low Hdl/High Triglycerides: Impact on Global Health Outcomes (AIM-HIGH) Trial. American Heart Journal, 161, 538-543. https://doi.org/10.1016/j.ahj.2010.12.007
Keech, A., Simes, R.J., Barter, P., Best, J., Scott, R., Taskinen, M.R., et al. (2005) Effects of Long-Term Fenofibrate Therapy on Cardiovascular Events in 9795 People with Type 2 Diabetes Mellitus (the FIELD Study): Randomized Controlled Trial. The Lancet, 366, 1849-1861. https://doi.org/10.1016/S0140-6736(05)67667-2