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Title GERIATRIC NUTRITIONAL RISK INDEX AND ITS ASSOCIATION WITH MORTALITY AMONG INCIDENT HAEMODIALYSIS PATIENTS |
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Type Poster Presentation |
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Theme 18th Asian Colloquium in Nephrology (18th ACN 2019) |
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Topic Dialysis: Nutrition |
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Main Author Seema Aithal1 |
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Presenting Author Seema Aithal1 |
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Co-Author Rajeswari Moothathamby1 Tripti Singh1 Rajiva Ibakkanavar1 Nandakumar Mooppil1 |
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Department / Institution / Country Medical services / The National Kidney Foundation / Singapore1 |
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Abstract Content: Introduction, Method, Result, Conclusion Introduction Geriatric nutritional risk index (GNRI) has been used to assess nutritional risk and the related morbidity and mortality in varied healthcare settings including ESRD patients. We studied the association between GNRI and all-cause mortality among incident haemodialysis (HD) patients. Additionally we investigated the relationship between GNRI and all-cause hospitalisations. Methods We included incident HD patients between January, 2010 and December, 2017 in this retrospective observational study. Patients were followed up for one year after a 6 month exposure period until first of the following – death, withdrawal or end of study (Dec 31st,2018). The exposure of interest was GNRI score. Patients were categorized into high and low GNRI groups based on cutoff value (93.49) derived using ROC analysis for all-cause mortality. We also stratified patients according to GNRI quartiles (Q1 ≤89.35, Q2 89.36–93.82, Q3 93.83–97.78 and Q4 97.79+). Primary outcome was all-cause mortality. Cox regression and Negative binomial regression models were used to determine associations with mortality and hospitalisation among the GNRI groups. Results In our cohort of 2736 patients (mean age 60.4±11.4 years, 56.3% male, 58.1% Chinese and 70.4% with diabetes) the median GNRI was 93.8 (89.3, 97.8) and 144 (5.3%) patients died during the one year follow-up. GNRI Low group (<93.49) had significantly higher hazard of all-cause mortality (aHR 2.07, 95% CI 1.44–2.98, p<0.001) after adjusting for potential confounders. The adjusted hazard of death for GNRI quartiles was the highest in Q1 (aHR 2.55, 95% CI 1.45-4.47) compared to Q4 (reference), p =0.001. After multivariate adjustment the GNRI Low group had 18% higher incidence of hospitalisation (IRR 1.18, 95% CI 1.07–1.29, p=0.001) compared to GNRI High group. Conclusion GNRI is useful in predicting mortality among incident HD patients. Low GNRI score was associated with increased risk of all-cause mortality and hospitalisation. |