期刊
KIDNEY & BLOOD PRESSURE RESEARCH
卷 43, 期 6, 页码 1878-1889出版社
KARGER
DOI: 10.1159/000495999
关键词
Geriatric nutritional risk index; Hemodialysis; Mortality; Cardiovascular disease
资金
- National Natural Science Foundation of China [81800616]
- Chongqing science and health joint medical research project [2018NXM040]
Background/Aims: Geriatric nutritional risk index (GNRI) was developed as a nutrition-related risk index and was reported in different populations as associated with the risk of all-cause and cardiovascular morbidity and mortality. Therefore, GNRI can be used to classify patients according to a risk of complications in relation to conditions associated with protein-energy wasting (PEW). However, not all reports pointed to the prognostic ability of the GNRI. The purpose of this study was to assess the associations of GNRI with mortality in chronic hemodialysis patients. Methods: We electronically searched original articles published in peer-reviewed journals from their inception to September 2018 in The PubMed, Embase, and the Cochrane Library databases. The primary outcome was all-cause and cardiovascular mortality. We pooled unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) using Review Manager 5.3 software. Results: A total of 10,739 patients from 19 cohort studies published from 2010 to 2018 were included. A significant negative association was found between the GNRI and all-cause mortality in patients with chronic hemodialysis (OR, 0.90; 95% CI, 0.84-0.97, p = 0.004) (per unit increase) and (OR, 2.15; 95% CI, 1.88-2.46, p < 0.00001) (low vs. high GNRI). Moreover, there was also a significant negative association between the GNRI (per unit increase) and cardiovascular events (OR, 0.98; 95% CI, 0.97-1.00, p = 0.01), as well as cardiovascular mortality (OR, 0.89; 95% CI, 0.80-0.99, p = 0.03). Conclusion: Our findings supported the hypothesis that the low GNRI is associated with an increased risk of all-cause and cardiovascular mortality in chronic hemodialysis patients. Based on our literature review, GNRI has been found to be an effective tool for identifying patients with nutrition-related risk of all-cause and cardiovascular disease. (C) 2018 The Author(s) Published by S. Karger AG, Basel
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