ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: SA-PO579

The Geriatric Nutritional Risk Index (GNRI) to IL-6 ratio as a Predictor of Mortality in a Long-Term Follow-Up of Hemodialysis Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Miyamoto, Tetsu, Kidney Center, University of Occupational and Environmenttal Health School of Medicine, Kitakyushu, Japan
  • Shirouzu, Tomohiro, 2nd Department of Internal Medicine, Univiersity of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
  • Nagai, Yoichiro, 2nd Department of Internal Medicine, Univiersity of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
  • Ishida, Hiroshi, 2nd Department of Internal Medicine, Univiersity of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
  • Furuno, Ikutaro, Kidney Center, University of Occupational and Environmenttal Health School of Medicine, Kitakyushu, Japan
  • Nakazono, Kazutoshi, 2nd Department of Internal Medicine, Univiersity of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
  • Hasegawa, Emi, Kidney Center, University of Occupational and Environmenttal Health School of Medicine, Kitakyushu, Japan
  • Kataoka, Masaharu, 2nd Department of Internal Medicine, Univiersity of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
Background

Persistent inflammation is an important cause of protein-energy wasting, which is a potent predictor of mortality. Therefore, regular monitoring of inflammatory biomarkers concurrently with nutritional risk screening may be clinically useful for estimating mortality risk in dialysis patients.

Methods

In this multicenter prospective cohort study comprising 325 maintenance hemodialysis patients (38% female; median age, 66 years; age range, 20-91years), we investigated the effect of the ratio of geriatric nutritional risk index (GNRI) to plasma C-reactive protein (CRP), Interleukin-6 (IL-6) and Pentraxin 3 (PTX3) levels on 10-year all-cause mortality. We used Cox proportional hazards models to estimate mortality risk.

Results

A total of 170 (52.3%) patients died during the observation period. When adjusting for age, sex, dialysis vintage, diabetes mellitus and cardiovascular disease, patients with higher log GNRI/IL-6 had a significantly lower mortality risk (Hazard ratio [HR]: 0.58, 95%CI: 0.41-0.82; P=0.002). Higher log GNRI/CRP (HR:0.74, 95%CI:0.62-0.91, P=0.006) and higher log GNRI/PTX3 (HR:0.46, 95%CI:0.22-0.93, P=0.03) are also related to lower mortality risk.

Conclusion

The ratio of GNRI to plasma inflammatory proteins levels, especially the ratio of GNRI to IL-6, may be a useful biomarker for assessing mortality risk in hemodialysis patients. Nutritional risk screening is expected to improve the mortality prediction power of inflammatory biomarkers.