SP384GERIATRIC NUTRITIONAL RISK INDEX : A SIMPLE NUTRITION SCREENING TOOL CORRELATES WITH UNIQUE HEALTH CONDITIONS IN NONDIALYSIS CKD PATIENTS

Malnutrition is prevalent in patients with chronic kidney disease (CKD). However, current nutrition screening tools are not specific to the CKD population. In the present study, we aimed to investigate whether the geriatric nutritional risk index (GNRI), a simple tool designed for assessing nutrition-related risks in the elderly population, is associated with unique aspects of CKD such as fluid status, residual renal function, proteinuria, and inflammation, and whether it predicts clinical outcomes. The GNRI was calculated by incorporating serum albumin and anthropometric measurements in 326 patients with nondialysis stage 3–5 CKD who were followed up from September 2011 to March 2017 for end-stage renal disease (ESRD) and the composite outcome of all-cause death and cardiovascular events. Patients were stratified into tertiles according to baseline GNRI levels. Patients in the lowest GNRI tertile were more likely to have significantly higher levels of overhydration, proteinuria, and serum inflammatory markers and tended to have lower lean body mass and estimated glomerular filtration rate when compared with patients in the middle and upper GNRI tertiles. In multivariate linear regression analyses, the GNRI was independently associated with overhydration, proteinuria, and interleukin-6. During a median follow-up of 4.9 years, 101 patients developed ESRD; 40 deaths, and 68 cardiovascular events occurred. Patients in the lowest GNRI tertile had significantly increased risks of ESRD (hazard ratio (HR): 3.15, 95% confidence interval (CI): 1.95–5.07, p < 0.001) and the composite outcome (HR: 1.79, 95% CI: 1.10–2.92, p = 0.019) in fully adjusted models (reference: middle and upper GNRI tertiles). The GNRI takes CKD-specific health conditions into account. In addition, CKD patients with lower GNRI scores had a significantly higher risk of adverse clinical outcomes. Our findings suggest that the GNRI is an appropriate tool for nutrition screening and a prognostic predictor among patients with nondialysis stage 3–5 CKD.

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The use of the Geriatric Nutritional Risk Index (GNRI) as a simplified nutritional screening tool

American Journal of Clinical Nutrition ◽

10.1093/ajcn/87.6.1966 ◽

2008 ◽

Vol 87 (6) ◽

pp. 1966-1967 ◽

Cited By ~ 15

Author(s):

Emanuele Cereda ◽

Carlo Pedrolli

Keyword(s):

Screening Tool ◽

Risk Index ◽

Nutritional Risk ◽

Geriatric Nutritional Risk Index ◽

Nutritional Screening ◽

Nutritional Risk Index

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Evaluation of the effectiveness of eight screening tools in detecting risk of malnutrition in cirrhotic patients: the KIRRHOS study

British Journal Of Nutrition ◽

10.1017/s0007114519002277 ◽

2019 ◽

Vol 122 (12) ◽

pp. 1368-1376 ◽

Cited By ~ 2

Author(s):

Alexandra Georgiou ◽

Georgios V. Papatheodoridis ◽

Alexandra Alexopoulou ◽

Melanie Deutsch ◽

Ioannis Vlachogiannakos ◽

...

Keyword(s):

Liver Disease ◽

Screening Tool ◽

Nutritional Assessment ◽

Risk Index ◽

Screening Tools ◽

Nutritional Risk ◽

Risk Screening ◽

Nutritional Risk Index ◽

Nrs 2002 ◽

Cirrhotic Patients

AbstractMalnutrition risk screening in cirrhotic patients is crucial, as poor nutritional status negatively affects disease prognosis and survival. Given that a variety of malnutrition screening tools is usually used in routine clinical practice, the effectiveness of eight screening tools in detecting malnutrition risk in cirrhotic patients was sought. A total of 170 patients (57·1 % male, 59·4 (sd 10·5) years, 50·6 % decompensated ones) with cirrhosis of various aetiologies were enrolled. Nutritional screening was performed using the Malnutrition Universal Screening Tool, Nutritional Risk Index, Malnutrition Screening Tool, Nutritional Risk Screening (NRS-2002), Birmingham Nutritional Risk Score, Short Nutritional Assessment Questionnaire, Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) and Liver Disease Undernutrition Screening Tool (LDUST). Malnutrition diagnosis was defined using the Subjective Global Assessment (SGA). Data on 1-year survival were available for 145 patients. The prevalence of malnutrition risk varied according to the screening tools used, with a range of 13·5–54·1 %. RFH-NPT and LDUST were the most accurate in detecting malnutrition (AUC = 0·885 and 0·892, respectively) with a high sensitivity (97·4 and 94·9 %, respectively) and fair specificity (73·3 and 58 %, respectively). Malnutrition according to SGA was an independent prognostic factor of within 1-year mortality (relative risk was 2·17 (95 % CI 1·0, 4·7), P = 0·049) after adjustment for sex, age, disease aetiology and Model for End-stage Liver Disease score, whereas nutrition risk according to RFH-NPT, LDUST and NRS-2002 showed no association. RFH-NPT and LDUST were the only screening tools that proved to be accurate in detecting malnutrition in cirrhotic patients.

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Penerapan algoritma proses asuhan gizi terstandar berbasis skrining gizi

Jurnal Gizi Klinik Indonesia ◽

10.22146/ijcn.18880 ◽

2014 ◽

Vol 11 (1) ◽

pp. 20

Author(s):

Susetyowati Susetyowati ◽

Hamam Hadi ◽

Ahmad Husein Asdie ◽

Mohammad Hakimi

Keyword(s):

Protein Intake ◽

Nutrient Intake ◽

Screening Tool ◽

Nutritional Risk ◽

Care Process ◽

Nutrition Screening ◽

Nutrition Care ◽

Average Intake ◽

Nutrition Care Process ◽

Nutrition Screening Tool

Background: Malnutrition is one common problem for hospitalized patient, estimated between 20-60%. American Dietetic Association (ADA) recommends a standardized Nutrition Care Process (SNCP) that ensures services and outcomes in the quality management of nutrition care to all patients based on an individual basis and scientific facts. In Indonesia was developed nutrition screening tool, namely the Simple Nutrition Screening Tool (SNST) which was valid and reliable.Objective: The study was to determine the effect of SNCP based on screening to improve nutrient intake and nutritional status.Method: The method using a 2x2 factorial design, with 4 groups which are: screened with Nutritional Risk Screening (NRS) and get hospital-based SNCP (A1B1); screened with NRS and algorithm SNCP (A1B2); screened with SNST and get hospital-based SNCP (A2B1); screened with the SNST and get algorithm SNCP (A2B2).Results: Nutritional screening interventions using NRS and SNST method can increase the energy and protein intake also Mid-Upper Arm Circumference (MUAC). There is no relationship between algorithm SNCP with nutrient intake and nutritional status, although the average intake of energy, protein, MUAC and albumin was better in the algorithm SNCP than in hospital-based SNCP. The interaction between the SNST and algorithm SNCP have better mean intake of energy, protein and MUAC changes than other groups. The size of the effect of energy intake, protein intake, and MUAC was 129 kcal; 4.6 g; and 0.35 cm, respectively.Conclusion: Interaction between an SNST and algorithm SNCP have a better average intake of energy, protein, and MUAC compared with other groups.

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Comparison of Nursing Records and the Catholic Medical Center Nutritional Risk Screening as a Nutrition Screening Tool for Intensive Care Unit Patients

Clinical Nutrition Research ◽

10.7762/cnr.2015.4.1.56 ◽

2015 ◽

Vol 4 (1) ◽

pp. 56

Author(s):

Gyu Jin Heo ◽

Hye Jin Kim ◽

Jeong Im Hong

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Screening Tool ◽

Medical Center ◽

Nutritional Risk ◽

Risk Screening ◽

Nutrition Screening ◽

Nutrition Screening Tool ◽

Nutritional Risk Screening

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Triagem nutricional em adultos hospitalizados

Revista de Nutrição ◽

10.1590/s1415-52732008000500011 ◽

2008 ◽

Vol 21 (5) ◽

pp. 589-601 ◽

Cited By ~ 9

Author(s):

Mariur Gomes Beghetto ◽

Bibiana Manna ◽

Andréia Candal ◽

Elza Daniel de Mello ◽

Carisi Anne Polanczyk

Keyword(s):

Screening Tool ◽

Nutritional Assessment ◽

Risk Index ◽

Mini Nutritional Assessment ◽

Nutritional Risk ◽

Nutritional Screening ◽

Nutrition Risk ◽

Nutritional Risk Index ◽

Assessment Questionnaire ◽

Nutritional Risk Screening

Em hospitais, o objetivo de um procedimento de triagem nutricional é identificar indivíduos desnutridos ou em risco de desnutrição, possibilitando intervenção nutricional precoce e melhor alocação de recursos. Diferentes métodos são apresentados na literatura para esta finalidade: Malnutrition Screening Tool, Short Nutritional Assessment Questionnaire, Nutritional Risk Index, Nutrition Risk Score, Nutritional Risk Screening, Mini Nutritional Assessment, Malnutrition Universal Screening Tool, Nutritional Screening Tool, Nutritional Screening Equation. No entanto, o emprego de muitos destes instrumentos está limitado pela inadequada metodologia empregada na derivação e/ou validação, pela seleção de grupos específicos de pacientes, pela pouca praticidade ou por necessidade de um especialista para seu emprego. Na ausência de um padrão de referência para emitir o diagnóstico nutricional, desfechos clínicos relevantes devem balizar a derivação e a validação de novos instrumentos. Este trabalho descreve os instrumentos de triagem nutricional acima referidos e apresenta considerações quanto ao seu emprego para adultos hospitalizados não selecionados.

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