3846 MALNUTRITION RISK IN HEMODIALYSIS PATIENTS AND SCREENING TOOLS PROGNOSIS: GNRI, CREATININE INDEX AND SPEW

Abstract Background and Aims nutritional status clearly has a great impact on the prognosis of maintenance hemodialysis patients. Therefore, its management should be a priority and risk screening frequent and easily implemented, based on the biochemical and clinical routine parameters already available. Many tools fit these simple criteria, namely simple Protein Energy Wasting score (sPEW), Geriatric Nutritional Risk Index (GNRI) and Creatinine Index (Cr Index). These scores are associated with a high mortality and morbidity risk in hemodialysis (HD) patients. The objective of this study was to assess the performance of these tools regarding the estimation of all-cause mortality, in a 45-months follow-up of a large patient cohort. Method Historical cohort study of HD pts from 25 outpatient clinics. sPEW, GNRI and Cr Index were estimated. Kaplan-Meier estimator and univariable Cox regression models to analyze time until death were used. To compare survival curves the log-rank test or Tarone test were used, as appropriate. The level of significance α = .05 was considered. All data were analyzed using SPSS 22.0 (IBM Corp. Released 2013. IBM SPSS Statistics for Windows. Armonk, NY, USA: IBM Corp). Results We analyzed 2322 pts, 59% males, 31.7% diabetic, with a median age of 70 years (P25 = 60, P75 = 79) followed up for a maximum of 45-month (P25 = 31; P75 = 45). All-cause mortality was observed in 778 pts (33.5%). To assess the mortality risk, the exposures GNRI and CR Index, were discretized using quartiles. GNRI The median was 106.6 (P25 = 99.4, P75 = 114.2). The log-rank test results showed a significantly lower survival for patients in GNRI Q1 category (GNRI ≤ 99.4). A p-value