Kidney Week

Abstract: SA-OR018

Nutritional Status as Predictor of Mortality in Older Adults with AKI

Session Information

• AKI Trials, Therapeutics, and Risk Stratification
  October 24, 2026 | Location: Room 603, Convention Center
  Abstract Time: 05:50 PM - 06:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Gómez, Juan Alberto, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Juan Alberto Gómez, MD

• Alcantar Vallin, Maria de la Luz, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Maria de la Luz Alcantar Vallin, MD

• Martínez Gallardo González, Alejandro, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Alejandro Martínez Gallardo González

• Medina, Ramon, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Ramon Medina, MD

• Navarro Blackaller, Guillermo, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Guillermo Navarro Blackaller, MD

• Chavez, Jonathan, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Jonathan Chavez, MD, PhD

• Mendoza Gaitán, Héctor Eduardo, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Héctor Eduardo Mendoza Gaitán, MD

• Garcia-Garcia, Guillermo, Universidad de Guadalajara, Guadalajara, Jal., Mexico

Guillermo Garcia-Garcia, MD, FASN

• Renoirte, Karina, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Karina Renoirte, PhD

• Cruz Aragon, Fernando, Universidad de Guadalajara, Guadalajara, Jal., Mexico

Fernando Cruz Aragon, MD

• Martínez Aguilar, Alma Isela, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Alma Isela Martínez Aguilar, MD

• De la Torre De la Vega, Ixchel, Universidad de Guadalajara, Guadalajara, Jal., Mexico

Ixchel De la Torre De la Vega, MD

• Tanaka-Gutiérrez, Jarumi Andrea, Universidad de Guadalajara, Guadalajara, Jal., Mexico

Jarumi Andrea Tanaka-Gutiérrez

Background

Older adults (OA) exhibit the highest incidence of acute kidney injury (AKI), with outcomes influenced by comorbidities, frailty, and malnutrition. Nutritional status, a potentially modifiable factor, has not been extensively evaluated as a mortality predictor in hospitalized OA with AKI. Our purpose was to report on the mortality risk provided by the nutritional status, comorbidities, and biochemical parameters in OA with AKI.

Methods

In this prospective cohort study (July 2024–July 2025) conducted at a tertiary geriatric unit, hospitalized OA with AKI, diagnosed according to KDIGO criteria, underwent a comprehensive nutritional assessment within 48 hours of admission. The Geriatric Nutritional Risk Index (GNRI), Mini Nutritional Assessment, anthropometric measurements, and biochemical markers were recorded. The primary outcome was in-hospital all-cause mortality; secondary outcomes included the analysis of all-cause mortality according to nutritional and clinical factors, such as dysphagia, hyporexia, and GNRI quartiles (Q1–Q4). Logistic regression models were used to identify independent predictors of mortality, and all models were adjusted for AKI severity.

Results

Of 742 admissions, 187 patients met the inclusion criteria. The median age was 76.8 years, and 50% were male. GNRI quartile analysis demonstrated a progressive deterioration in anthropometric and biochemical markers from Q4 to Q1. Mortality was higher in the high-risk GNRI group (42.2% vs 30.1%); however, this difference did not reach statistical significance (p = 0.098). In adjusted analyses, dysphagia (adjusted odds ratio [aOR] 6.11; 95% CI 1.82–20.51; p = 0.003), hyporexia (aOR 2.24; 95% CI 1.02–4.92; p = 0.044), and lower GNRI (aOR 1.07 per unit decrease; 95% CI 1.02–1.13; p = 0.004) were independently associated with increased mortality. In contrast, a higher mid-upper arm circumference was independently associated with a protective effect (aOR 0.78; 95% CI 0.67–0.91; p = 0.001).

Conclusion

In OA hospitalized with AKI, poor nutritional status, particularly dysphagia, hyporexia, and lower GNRI, was independently associated with increased in-hospital mortality, whereas preserved muscle mass was protective. Early, simple, bedside nutritional assessments may help guide targeted interventions to improve outcomes in this high-risk population.