Author(s)

Ayako Hasegawa¹, Norio Hanafusa², Masayuki Okazaki³, Mizuki Komatsu³, Hiroshi Kawaguchi³, Ken Tsuchiya², Kosaku Nitta^1*

¹Department of Medicine, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan.
²Department of Blood Purification, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan.
³Department of Nephrology, Jyoban Hospital, Fukushima, Japan.

Background: The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been shown to be a predictor of cardiovascular (CV) outcomes in the general population. Objectives: The aim of this study was to determine whether the combination of GNRI and TG/HDL-C ratio is a predictor of all-cause mortality and CV deaths in maintenance hemodialysis (MHD) patients. Methods: We performed a retrospective, observational cohort study in which we enrolled 341 MHD patients from a single center in Japan who had been followed up for a mean of 48.0 ± 12.7 months. The outcomes were defined as the occurrence of all-cause mortality and CV deaths during the follow-up period. Baseline GNRI and TG/HDL-C ratios were investigated for associations with outcomes by using Cox proportion hazards models adjusted for demographic parameters. Results: Overall, 101 of the subjects had died, of whom 52 died due to CV events during the mean follow-up period of 48.0 ± 12.7 months. The patients were grouped into four categories according to a median GNRI < 95.3 or ≥95.3 and a median TG/HDL-C ratio < 2.09 or ≥2.09. The group with a GNRI ≥ 95.3 and TG/HDL-C ≥ 2.09 had significantly lower overall and CV mortality rate when compared with the other three groups. Conclusion: The combination of GNRI and TG/HDL-C ratio is an easily accessible marker for predicting all-cause mortality and CV deaths in MHD patients.

GNRI, Triglyceride, HDL-Cholesterol, Mortality, Hemodialysis

Hasegawa, A. , Hanafusa, N. , Okazaki, M. , Komatsu, M. , Kawaguchi, H. , Tsuchiya, K. and Nitta, K. (2017) An Invitation of the Combination of the Geriatric Nutritional Risk Index and the Triglyceride to High-Density Lipoprotein Cholesterol Ratio as a Mortality Predictor in Maintenance Hemodialysis Patients. International Journal of Clinical Medicine, 8, 86-97. doi: 10.4236/ijcm.2017.82008.