Value of the Geriatric Nutritional Risk Index in predicting mortality of elderly patients undergoing hemodialysis

Abstract

To explore the reliability of the Geriatric Nutritional Risk Index (GNRI) as a mortality predictor in elderly patients undergoing hemodialysis (HD). A total of 125 maintenance HD patients aged >60 years old who had received dialysis for over 6 months before entry was retrospectively examined. The values of GNRI were calculated, and death was taken as the end point. The patients were divided into 4 groups according to the quartiles of GNRI values. All-cause and cardiovascular mortality were calculated using Kaplan-Meier and cox proportional-hazards analyses, and ROC curve was adopted for analyzing the predicting value of GNRI on mortality. The GNRI of the four groups were ≤92.06, 92.07-96.15, 96.16-101.25, ≥101.26, respectively. Kaplan-Meier survival rate was significantly different among 4 groups for all-cause and cardiovascular mortality. Cox regression model analysis demonstrated that the GNRI was a predictor for all cause (HR=0.940, P=0.001, 95%CI: 0.907-0.974) and cardiovascular mortality (HR=0.906, P<0.001, 95%CI: 0.863-0.951). The area under ROC curve was 0.667 (P=0.001) for all-cause mortality and 0.717 (P=0.001) for cardiovascular mortality. The GNRI is a reliable predictor for all-cause mortality in maintainance HD patients, but more multi-center studies with larger samples are still needed.