Geriatric Nutritional Risk Index for independent walking function in maintenance hemodialysis patients: A single‐facility retrospective cohort study

Abstract

Aim The target Geriatric Nutritional Risk Index (GNRI) for patients on chronic maintenance hemodialysis is unclear. We aimed to determine the relationship between the GNRI and independent walking ability in such patients. Methods In the present retrospective cohort study, 90 patients receiving chronic maintenance hemodialysis were included. Logistic regression analyses were carried out to evaluate the relationship between the GNRI and independent walking ability. Receiver operating characteristic curve analysis was carried out to determine the cut‐off GNRI for predicting independent walking ability. Results Multivariate logistic regression analysis showed significant differences in age (odds ratio [OR] 0.8, 95% confidence interval [CI] 0.6–0.9), creatinine generation rate percentage (OR 1.1, 95% CI 1.0–1.2), GNRI (OR 1.4, 95% CI 1.1–1.8; P < 0.01) and urea removal rate (OR 0.3, 95% CI 0.1–0.9; P < 0.05). The cut‐off GNRI for independent walking ability was 86.7 (area under the curve 0.80, sensitivity 92.1%, specificity 66.7%, positive hit ratio 86.6%, negative hit ratio 78.3%). The factors correlated with survival in the univariate analysis were the GNRI, equilibrated Kt/V, urea removal rate, clear space rate, salt intake amount (P < 0.01), number of days of hospitalization and %creatinine generation rate (P < 0.05). The Cox proportional hazard regression model showed an OR of 0.77 (95% CI 0.32–1.8) at a GNRI <86/GNRI ≥86. In the multivariate survival analysis, we observed no significant differences in any of the factors. Conclusions GNRI was correlated with walking ability, which indicated that GNRI might predict future walking ability; also, a GNRI of 87 might be the target for maintaining walking ability. Geriatr Gerontol Int 2018; 18: 1556–1561.

Relationship between probable sarcopenia and nutritional disorders as evaluated using the Geriatric Nutritional Risk Index and serum phosphorus concentration in maintenance dialysis patients: A cross-sectional study

“…Referring to the previous study investigating the relationship between sarcopenia and GNRI, muscle strength and muscle mass were found to be related to GNRI, 17 and the cut-off value of GNRI for maintaining gait ability on their own was 86.7. 18 To estimate sarcopenia, we considered that the findings of the previous studies support the results in our present study, which are useful to investigate whether the value GNRI should be <90 in assessing nutritional status. Furthermore, in the analysis by age group, we should note that GNRI decreases along with increasing age; nearly half of all patients aged >70 years had GNRI of <90.…”

The utility of geriatric nutritional risk index to predict outcomes in chronic limb‐threatening ischemia

“…Multivariate analysis accounted for difference in white blood cell counts, hemoglobin, chronic kidney disease, diabetes mellitus, preprocedural WIfI clinical stages, and pre-intervention ABI (posterior tibial). GNRI, geriatric nutritional risk index; HR, hazard ratio; MALE, major adverse limb events [Color figure can be viewed at wileyonlinelibrary.com] ability, 27 likely related to its association with sarcopenia and bone density. 28,29 In our CLTI population, the GNRI results also correlate well with PIII, a surgical risk score validated for patients with CLTI undergoing bypass surgery to predict 1 year AFS.…”