Using the hemodialysis prognostic nutrition index and urea reduction ratio to predict morbidity and mortality: A pilot study of the 1995 council on renal nutrition national research question

Objective: To validate the use of the hemodialysis prognostic nutrition index (HPNI) in an alternate hemodialysis population and to determine if use of urea reduction ratio would improve use in outcome prediction for morbidity and mortality. Design: Prospective random cohort. Setting: Hospital based non-for-profit outpatient dialysis unit. Patients: Forty chronic hemodialysis patients, 50% men, 50% black, 16% diabetic, 67.2 mean months on hemodialysis, mean age 54.5 years. Interventions: None; observational; tracking of routinely collected demographic, biochemical, and clinical data. Main outcome measures: Number of times and days hospitalized, mortality Results: Plotting of HPNI against urea reduction ratio produced risk quadrants for hospitalization that were more predictive than HPNI alone. Conclusion: Application continues as a multicenter collaborative Council on Renal Nutrition National Research Question.