The Association of Geriatric Nutritional Risk Index and Total Lymphocytes Count with Mortality in Korean Hemodialysis Patients

Background: Our objective was to examine the association between the Geriatric Nutritional Risk Index (GNRI) and Total lymphocytes count (TLC) with mortality in Korean Hemodialysis Patients. Methods: We examined the GNRI and TLC of 120 maintenance hemodialysis patients and followed these patients for 120 months. Predictors for all-cause death were examined using life table analysis and the Cox proportional hazards model. Results: Life table analysis revealed that subjects with a GNRI < 90 (n = 19) had a lower survival rate than did those with a GNRI ≥ 90 (n = 101) (Wilcoxon test, P = 0.048), but subjects with a TLC < 1500/mm3 (n = 76)had a similar survival rate compared those with a TLC ≥ 1500/mm3 (n = 44) (Wilcoxon test, P = 0.500). Multivariate Cox proportional hazards analyses demonstrated that the GNRI was a significant predictor of mortality [hazard ratio (HR) 9.315, 95% confidence interval (CI) 1.161–74.753, P = 0.036], after adjusting for age, sex, presence of type 2 diabetes mellitus, Kt/V, nPCR and TLC. The association of a GNRI ≥ 90 with a TLC ≥ 1500/mm3 seemed to exclude the occurring of complications with moderate reliability. Conclusion: These results demonstrate that the GNRI may be a significant predictor of mortality in Korean hemodialysis patients. However, the use of TLC might improve the evaluation of nutritional risk and the identification of patients at risk of malnutrition.Figure 1. Total lymphocytes count and 120-month survival of hemodialysis patients. In both groups, survival rate during the follow-up period was similar. (life table analysis, P = 0.500).fx1