Abstract: SA-PO1014
Comparison of Three Nutritional Screening Tools for Predicting Mortality in Maintenance Hemodialysis Patients
Session Information
- Hemodialysis and Frequent Dialysis - V
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Chen, Junzhi, Nanfang Hospital, Guangzhou, China
- Liang, Min, Nanfang Hospital, Guangzhou, China
Background
There has been a great consensus that the key first step in the evaluation of nutritional status is to identify “at risk” status by using the validated nutritional screening tools. However, an effective and simple nutrition screening tool has not been identified in maintenance hemodialysis (MHD) patients. To the best of our knowledge, the comparison of mortality predictability between the objective score of nutrition on dialysis (OSND) and the malnutrition-inflammation score (MIS) or the geriatric nutritional risk index (GNRI) has not been conducted in previous studies.
Methods
A cohort of 1,025 MHD patients were enrolled from 8 hospitals. The MIS, OSND, and GNRI were measured at baseline. All-cause mortality and cardiovascular (CV) mortality were the major study outcomes. Harrell’s C statistics were derived to examine the discrimination between three tools and mortality.
Results
The median follow-up duration was 28.1 months. The MIS (per standard deviation (SD) increase, HR =1.35, 95% CI: 1.18–1.55), the OSND (per SD decrease, HR =1.24, 95% CI: 1.09–1.42), and the GNRI (per SD decrease, HR =1.26, 95% CI: 1.10–1.43) were all significantly associated with the risk of all-cause mortality. More importantly, the mortality predictability of the MIS appears similar to the GNRI (P = 0.182) and greater than the OSND (MIS vs. OSND: P = 0.001; GNRI vs. OSND: P = 0.045). Similar results were found for CV mortality.
Conclusion
Each of the three nutritional screening tools was significantly associated with an increased risk of all-causes and CV mortality. The mortality predictability of the MIS was similar to the GNRI and greater than the OSND.
Results of Harrell’s C Statistic
| Variables | Harrell’s C Statistic (95%CI) | P-value | |
| All-cause mortality | |||
| MIS | 0.62 (0.58, 0.66) | Ref. | 0.001 |
| OSND | 0.56 (0.52, 0.60) | 0.001 | Ref. |
| GNRI | 0.6 (0.56, 0.64) | 0.182 | 0.045 |
| CV mortality | |||
| MIS | 0.62 (0.58, 0.67) | Ref. | 0.001 |
| OSND | 0.55 (0.50, 0.60) | 0.001 | Ref. |
| GNRI | 0.6 (0.55, 0.65) | 0.226 | 0.035 |