Geriatric Nutritional Risk Index as a Prognostic Factor in Peritoneal Dialysis Patients

Abstract

Background The Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce. Methods We reviewed the medical records at Yeungnam University Hospital in Korea to identify all adults (>18 years) who received PD; 486 patients were enrolled in the study. Results The initial low, middle, and high GNRI tertiles included 162, 166, and 158 patients respectively. Significant correlations were noted between the initial GNRI and body mass index, creatinine, albumin, arm circumference, fat mass index, and comorbidities. The cut-off value for the time-averaged GNRI over 1 year was 96.4, and the sensitivity and specificity for a diagnosis of a decline in lean mass were 77.1% and 40.0% respectively. A multivariate analysis adjusted for age, risk according to the Davies comorbidity index, and C-reactive protein showed that an low initial GNRI tertile was associated with mortality in PD patients. Conclusions The GNRI is a simple method for predicting nutrition status and clinical outcome in PD patients.