Unplanned hemodialysis initiation and low geriatric nutritional risk index scores are associated with end-stage renal disease outcomes.
Unplanned hemodialysis initiation and low geriatric nutritional risk index scores are associated with end-stage renal disease outcomes.
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DOI：
10.1038/s41598-022-14123-y
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发表时间：
2022-06-30
影响因子：
4.6
通讯作者：
Azuma, Haruhito
中科院分区：
文献类型：
--
作者：
Maenosono, Ryoichi;Fukushima, Tatsuo;Kobayashi, Daisuke;Matsunaga, Tomohisa;Yano, Yusuke;Taniguchi, Shunri;Fujiwara, Yuya;Komura, Kazumasa;Uehara, Hirofumi;Kagitani, Maki;Hirano, Hajime;Inamoto, Teruo;Nomi, Hayahito;Azuma, Haruhito
终末期肾病(ESRD)患者营养状况低，死亡风险高。老年营养风险指数(GNRI)是营养不良的预测指标。然而，非计划性血液透析(HD)和GNRI与死亡率之间的关联仍不清楚。共有162例患者在本院接受HD治疗。随机分为两组：非计划中心静脉置管组(CVC；n = 62)和预置血管通路组(n = 10 0)。两组患者在性别、年龄、恶性肿瘤、高血压、血管疾病等方面差异无统计学意义，但从首次透析至透析开始的时间(0次vs.6次，p <； 0.001)和首次就诊至HD开始的天数(5次vs.175天，p <； 0.001)有显著差异。中心静脉插入组在开始时GNRI评分显著降低(85.7vs.99.0，p <； 0.001)。调整后的危险比分别为4.002和3.018的GNRI评分和频率。CVC + 低GNRI组的3年生存率显著低于CVC组(p <； 0.0001)。CVC置入组1个月后GNRI明显低于CVC置入组。对于终末期肾病患者来说，由于延迟转诊至肾内科而导致的综合治疗不足是一个危险因素。
Patients with end-stage renal disease (ESRD) have a low nutritional status and a high mortality risk. The geriatric nutritional risk index (GNRI) is a predictive marker of malnutrition. However, the association between unplanned hemodialysis (HD) and GNRI with mortality remains unclear. In total, 162 patients underwent HD at our hospital. They were divided into two groups: those with unplanned initiation with a central venous catheter (CVC; n = 62) and those with planned initiation with prepared vascular access (n = 100). There were no significant differences in sex, age, malignant tumor, hypertension, and vascular disease, while there were significant differences in the times from the first visit to HD initiation (zero vs. six times, p < 0.001) and days between the first visit and HD initiation (5 vs. 175 days, p < 0.001). The CVC insertion group had significantly lower GNRI scores at initiation (85.7 vs. 99.0, p < 0.001). The adjusted hazard ratios were 4.002 and 3.018 for the GNRI scores and frequency, respectively. The 3-year survival rate was significantly lower in the CVC + low GNRI group (p < 0.0001). The GNRI after 1 month was significantly inferior in the CVC insertion group. Inadequate general management due to late referral to the nephrology department is a risk factor for patients with ESRD.
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10.2215/cjn.02190216
发表时间：
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