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Naito T, Doi T, Morii K, Usui K, Arita M, Yamashita K, Shigemoto K, Nishizawa Y, Mizuiri S, Sasaki K, Masaki T. Synergistic Effects of the Geriatric Nutritional Risk Index and the Modified Creatinine Index for Predicting Mortality in Patients on Hemodialysis. Nutrients 2022; 14:nu14122398. [PMID: 35745130 PMCID: PMC9230177 DOI: 10.3390/nu14122398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023] Open
Abstract
This study aimed to investigate whether a combined estimation of the geriatric nutritional risk index (GNRI) and the modified creatinine index (mCI) provides synergistic information for mortality in patients treated by chronic hemodialysis. We analyzed 499 patients on hemodialysis for five years. We set each cut-off value as the high (≥92) and low (<92) GNRI groups and the high (≥21 mg/kg/day) and low (<21 mg/kg/day) mCI groups, and divided them into four subgroups: G1, high GNRI + high mCI; G2, high GNRI + low mCI; G3, low GNRI + high mCI; and G4, low GNRI + low mCI. The survival rate was evaluated and time-to-event analysis was performed. All-cause death occurred in 142 (28%) patients. Kaplan−Meier curves showed that G2 and G4 had a significantly worse outcome (p < 0.05) than G1 but not G3. Using the multivariable-adjusted model, only G4 was significantly associated with all-cause mortality compared with G1. Our study suggests that the synergistic effects of the GNRI and the mCI are helpful in predicting all-cause mortality. The combination of these indices may be superior to a single method to distinguish patients who are well or moderately ill from potentially severely ill.
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Affiliation(s)
| | - Toshiki Doi
- Department of Nephrology, Ichiyokai Harada Hospital, Hiroshima 731-5134, Japan; (K.M.); (K.Y.); (K.S.); (Y.N.); (S.M.)
- Department of Kidney Disease and Community Medicine, Hiroshima University Hospital, Hiroshima 734-8551, Japan
- Correspondence: ; Tel.: +81-82-257-1506
| | - Kenichi Morii
- Department of Nephrology, Ichiyokai Harada Hospital, Hiroshima 731-5134, Japan; (K.M.); (K.Y.); (K.S.); (Y.N.); (S.M.)
- Department of Kidney Disease and Community Medicine, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Koji Usui
- Ichiyokai Clinic, Hiroshima 731-5133, Japan;
| | | | - Kazuomi Yamashita
- Department of Nephrology, Ichiyokai Harada Hospital, Hiroshima 731-5134, Japan; (K.M.); (K.Y.); (K.S.); (Y.N.); (S.M.)
| | - Kenichiro Shigemoto
- Department of Nephrology, Ichiyokai Harada Hospital, Hiroshima 731-5134, Japan; (K.M.); (K.Y.); (K.S.); (Y.N.); (S.M.)
| | - Yoshiko Nishizawa
- Department of Nephrology, Ichiyokai Harada Hospital, Hiroshima 731-5134, Japan; (K.M.); (K.Y.); (K.S.); (Y.N.); (S.M.)
| | - Sonoo Mizuiri
- Department of Nephrology, Ichiyokai Harada Hospital, Hiroshima 731-5134, Japan; (K.M.); (K.Y.); (K.S.); (Y.N.); (S.M.)
| | - Kensuke Sasaki
- Department of Nephrology, Hiroshima University Hospital, Hiroshima 734-8551, Japan; (K.S.); (T.M.)
| | - Takao Masaki
- Department of Nephrology, Hiroshima University Hospital, Hiroshima 734-8551, Japan; (K.S.); (T.M.)
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Kalantar-Zadeh K, Saville J, Moore LW. Unleashing the Power of Renal Nutrition in Value-Based Models of Kidney Care Choices: Leveraging Dietitians' Expertise and Medical Nutrition Therapy to Delay Dialysis Initiation. J Ren Nutr 2022; 32:367-370. [PMID: 35589046 DOI: 10.1053/j.jrn.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Kamyar Kalantar-Zadeh
- Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, CA, USA.
| | | | - Linda W Moore
- Department of Surgery, Houston Methodist Hospital, Houston, TX, USA
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