Evaluation of chronic kidney patients with geriatric nutritional risk index

Background and aims: Malnutrition in chronic kidney disease is an important cause of mortality and morbidity that causes the progression of the disease. Therefore, many different evaluation systems have been developed for systemic evaluation of malnutrition. Most evaluation systems contain subjective parameters and differ depending on the person who evaluates. Geriatric nutritional risk index (GNRI), which was created by using weight, height and serum albumin levels, has come to the forefront in recent years as a very simple and reliable method for evaluating patients' nutritional status. In our study, it was aimed to evaluate the nutritional status of chronic kidney patients with GNRI, an easy, simple, cheap and reliable method. Materials and methods: A total of 170 patients were included in the study, 81 male and 89 women with follow-up with the diagnosis of Stage 3-4-5 KBH, which was applied to The Nephrology Outpatient Clinic of Zonguldak Bülent Ecevit University Faculty of Medicine between November 2018 and November 2019. Patients with malignant disease, advanced lung and heart disease, and recently underwent major surgery were excluded. Presence of malnutrition in patients; biochemical parameters and Geriatric Nutritional Risk Index were calculated and evaluated. Statistical analysis was done using SPSS 19.0 program. The calculated p<0.05 was considered significant Results: In our study, the relationship between biochemical nutritional parameters and GNRI was evaluated. According to the highest positive likelihood ratio, the GNRI cut-off value was calculated as 110 for malnutrition.. Patients with low GNRI were found to have significantly lower BMI (p <0.05). In addition, serum albumin level, hemoglobin, calcium, total lymphocyte count, total protein levels, total iron binding capacity and GFR were significantly lower in patients with GNRI≤110 (p<0.05). Urea, creatinine, ferritin, parathormone levels and sedimentation values were also found to be significantly higher in patients with low GNRI (p <0.05). When another reliable malnutrition evaluation system, Malnutrition Inflammation Score (MIS) square, was evaluated, a statistically significant negative correlation was found (p <0.05 r = -0.715). Conclusion: Malnutrition is the leading cause of mortality in chronic kidney disease. Therefore, there are many different evaluation systems in malnutrition evaluation. Most evaluation systems contain subjective parameters and differ depending on the person who evaluates. Geriatric Nutritional Risk Index is calculated according to height, weight and serum albumin level and it is reliable as it is a simple, objective evaluation system. In our study, nutritional parameters of chronic kidney patients were evaluated with GNRI and it was observed that these parameters affected similarly with the studies performed. In addition, in our study, GNRI was a reliable evaluation system in comparison with another reliable evaluation system, Malnutrition Inflammation Score. When the relation of GNRI with nutritional parameters is also examined, it has been shown to be a reliable, simple, cheap and objective method in the evaluation of malnutrition in chronic kidney patients.