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

Abstract

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.