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

• Hemodialysis: Biomarkers, Translational Research
  November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Miyamoto, Tetsu, Kidney Center, University of Occupational and Environmenttal Health School of Medicine, Kitakyushu, Japan

Tetsu Miyamoto,

• Shirouzu, Tomohiro, 2nd Department of Internal Medicine, Univiersity of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan

Tomohiro Shirouzu,

• Nagai, Yoichiro, 2nd Department of Internal Medicine, Univiersity of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan

Yoichiro Nagai,

• Ishida, Hiroshi, 2nd Department of Internal Medicine, Univiersity of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan

Hiroshi Ishida,

• Furuno, Ikutaro, Kidney Center, University of Occupational and Environmenttal Health School of Medicine, Kitakyushu, Japan

Ikutaro Furuno,

• Nakazono, Kazutoshi, 2nd Department of Internal Medicine, Univiersity of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan

Kazutoshi Nakazono,

• Hasegawa, Emi, Kidney Center, University of Occupational and Environmenttal Health School of Medicine, Kitakyushu, Japan

Emi Hasegawa,

• Kataoka, Masaharu, 2nd Department of Internal Medicine, Univiersity of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan

Masaharu Kataoka,

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.