Geriatric nurritional risk index in diagnostics of malnutrition in patients on peritoneal dialysis

Abstract

Malnutrition is a prevalent concomitant disease in patients with chronic renal failure (CRF) on peritoneal dialysis (PD). Assessment of nutritional status is a necessary component of the complex treatment of these patients. Studying imformativeness of the geriatric nutritional risk index (GNRI) while assessing nutritional status in CRF patients on PD. Investigation was carried out in 112 patients with CRF on PD (50 men and 63 women aged 44±14 years) during 19±17 months. To assess nutritional status, a complex technique in modification by Bilbrey G.L.-Cohen T.L. was used as well as the malnutrition-inflammation score (MIS) and subjective global assessment (SGA). GNRI was calculated by the formula: GNRI=[1,489×albumin (g/dl)+[41,7×(body wt/ideal body wt)]. Disturbances of nutritional status were revealed based on the results of the complex technique in 57.1% of patients (mild disturbances – 35.7% and medium-severe–21.4%), on the results of MIS–in 53.6% (moderate – 47.3%, expressed–6.3%), on the results of SGA–in 52.7% (mild–25.9%, moderate–23.2%, expressed–3.6%), and on the results of GNRI–in 51.8% (low degree–27.7%, medium-high one–24.1%). GNRI inversely correlates with both the complex technique (r=0.665, p<0.0001) and MIS (r=-0.702, p<0.0001), and directly correlates with SGA (r=0.634, p<0.001). Comparative analysis of three patient groups–without risk of nutritional disturbances (GNRI>98), with a mild risk degree (GNRI 92-98), and with a medium-severe risk degree (GNRI<92) – revealed reliable differences in the majority of nutritional parameters: anthropometric ones (body mass index, triceps skinfold thickness, arm circumference, and arm muscle circumference), biochemical (hemoglobin, albumin, С-reactive protein, and triglycerides), and bioelectrical impedance analysis (body fat mass). GNRI is a simple technique available for the attending medical doctor as well as a highly informative test for assessment of patient’s nutritional status and diagnostics of malnutrition in CRF patients on PD.