Nutritional disorder in older adults tied to death risk in haemodialysis

Among older adults undergoing haemodialysis, nutritional disorder appears to be a risk factor for all-cause mortality and death after hospitalization for infection, a recent study has found.

Researchers conducted a prospective cohort analysis of 518 patients on haemodialysis. Nutritional disorder, also known as protein wasting, was identified using the Geriatric Nutritional Risk Index (GNRI). Outcomes were all-cause mortality, hospitalization for infections, and subsequent death.

Overall, 107 died over a median follow-up period of 5.0 years. Meanwhile, over a follow-up of 4.5 years, 169 patients were admitted for infections. Dividing patients according to GNRI tertiles revealed an inverse correlation between all-cause mortality and GNRI scores (log-rank p<0.001).

This association was confirmed in Cox hazard analysis, which showed that participants in the lowest GNRI tertile were >250 percent more likely to die of all causes (hazard ratio [HR], 2.6, 95 percent confidence interval [CI], 1.4–5.0; p_trend=0.002) than those in the top tertile.

In contrast, GNRI was only associated with hospitalization for infection in the crude model but no longer so after adjustments for covariates.

However, researchers found a significant link between low GNRI and death after hospitalization for infection (HR, 2.7, 95 percent CI, 1.3–5.6; p=0.007).

“Easy and objective detection of high-risk patients by the GNRI may lead to favourable long-term outcomes after hospitalization for infection through early nutritional intervention,” the researchers said. “Routine and repeated assessment of nutritional status using the GNRI will be helpful in individualized nutritional care.”