Use of the Geriatric Nutritional Risk Index for Nutritional Screening in Patients on Maintenance Hemodialysis

BACKGROUND: To explore the use of Geriatric Nutritional Risk Index (GNRI) to screen maintenance hemodialysis patients at nutritional risk in Taiwan. METHODS: GNRI was used to assess nutritional risk in 179 hemodialysis patients. Two sets of GNRI cutoff values and a ‘no nutrition-related’ risk assessment were used to divide patients into groups with different nutrition-related risks. For each classification method, clinical characteristics and various nutrition-related indices of patients at nutritional risk were compared. RESULTS: Approximately, 4%, 10%, 27%, and 59% of the 179 maintenance hemodialysis patients had major, moderate, low, and absent nutrition-related risk, respectively. There were significant differences in age, body mass index (BMI), duration of dialysis, albumin, blood urea nitrogen (BUN), creatinine, uric acid, cholesterol and triglyceride levels among major, moderate, low and absent nutritional risk groups (P < 0.05). Using a cutoff value of ≤ 91.2, 14% of the maintenance hemodialysis patients were malnourished. GNRI positively correlated with albumin, BUN, creatinine, glucose, and duration of dialysis (P < 0.05). CONCLUSIONS: The use of GNRI to screen for malnutrition in dialysis patients on maintenance should be supported with more validation studies. We recommend the combined use of GNRI and other validated tools for nutritional screening in maintenance dialysis patients.