Evaluation of the Efficacy of Using Gnri and Mis as a Predictor of Mortality in Elderly Hemodialysis Patients

Abstract

Background: Malnutrition is one of the most common geriatric syndromes in hemodialysis (HD) patients. Although there is no gold standard for  evaluating nutritional status in HD patients, the Subjective Global Assessment (SGA), Geriatric Nutritional Risk Index (GNRI), and  Malnutrition‑Inflammation Score (MIS) are widely used in clinical settings.

Aim: To examine the efficacy of using Geriatric Nutritional Risk Index (GNRI)  and Malnutrition‑Inflammation Score (MIS) as a predictor of mortality in elderly hemodialysis patients.

Subjects and Methods: A retrospective cohort  study was carried out in Malatya Training and Research Hospital’s Hemodialysis Unit between July 2018 and August 2022. Two hundred seventy-four  elderly hemodialysis patients were included in the study. Demographic characteristics, laboratory parameters, and anthropometric measurements of the  patients were reviewed. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 16.0 software (SPSS Inc.,  Chicago, IL, USA). Logistic regression analysis was performed to identify independent predictors of mortality.

Results: The mean age of 83 patients who  died was 70.00 ± 8.39 years and 47 (56.6%) of these patients were male. All-cause death occurred in 69 (71.1%) of 97 patients with an MIS of ≥6. All‑cause  death occurred in 24 (54.5%) of 44 patients with a GNRI score of <91.2. Accordingly, MIS (P < 0.001, OR = 1.376 [0.163–0.392]), GNRI (P = 0.001, OR =  −0.431 [1.189–1.990]), and age (P = 0.021, OR = 0.109 [0.818–0.984]) were found to be independent predictors of all-cause mortality.

Conclusions: GNRI  and MIS are important predictors of increased risk of mortality from all causes in elderly HD patients.