Abstract：
BACKGROUND:Malnutrition is common and associated with poor outcomes in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Recently, the geriatric nutritional risk index (GNRI) was reported as a novel tool for evaluating nutritional status. However, the association between GNRI and renal outcome, cardiovascular (CVD) events, and mortality in patients with CKD remains unclear. METHODS:A prospective cohort study with adult patients with CKD stages 1-4 was conducted at 39 centers around China starting in 2011. Patients were divided into quartiles (Q1, Q2, Q3, and Q4) according to their GNRI category. RESULTS:A total of 2791 CKD patients within a median follow-up of 4.38 years were included. A low GNRI quartile was independently associated with progression to ESRD, CVD events, and overall mortality. Compared to that in the Q1 group (the reference group), belonging to a higher GNRI quartile significantly reduced the risk of progression to ESRD in the crude and multivariate-adjusted models. Moreover, a significant inverse association was found between those in the high GNRI quartiles and overall mortality among patients with CKD (HR 0.25; 95% CI 0.15-0.43; p = 0.0007, Q4 vs. Q1) after multivariate adjustment. In addition, there was also a significant association between GNRI and CVD events (HR 0.57; 95% CI 0.39-0.84; p = 0.005, Q4 vs. Q1). Moreover, after adjusting for other confounders, only the Q3 group remained significantly fewer CVD events (HR 0.44; 95% CI 0.19-0.98; p = 0.04). CONCLUSIONS:These findings suggest that GNRI might be a useful prognostic tool for patients with CKD.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Xiong J,Wang M,Wang J,Yang K,Shi Y,Zhang J,Zhang B,Zhang L,Zhao J,Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE).doi
10.1007/s40620-019-00676-1subject
Has Abstractpub_date
2020-08-01 00:00:00pages
783-793issue
4eissn
1121-8428issn
1724-6059pii
10.1007/s40620-019-00676-1journal_volume
33pub_type
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