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Updated: Aug 7, 2025

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Malnutrition: A risk factor for vascular access problems.

Tolga Onur Badak1, Sibel Ada2

  • 1Department of Cardiovascular Surgery, Adana City Hospital, Adana, Turkey.

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PubMed
Summary

Malnutrition, identified by the Geriatric Nutritional Risk Index (GNRI), is linked to arteriovenous fistula patency in hemodialysis patients. Early detection of malnutrition before fistula creation may improve long-term fistula outcomes.

Keywords:
AV fistulaGeriatric nutritional risk indexcathetersdialysisdialysis accessnutrition

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Nutritional Science

Background:

  • Vascular access complications significantly impact hemodialysis patients' health and quality of life.
  • Native arteriovenous fistulas are the preferred vascular access method.
  • The Geriatric Nutritional Risk Index (GNRI) offers a reliable assessment of nutritional status.

Purpose of the Study:

  • To investigate the relationship between malnutrition, assessed by GNRI, and the patency of native arteriovenous fistulas in chronic hemodialysis patients.
  • To explore the potential of GNRI as a predictive tool for fistula longevity.

Main Methods:

  • A retrospective, observational study involving hemodialysis patients with arteriovenous fistulas.
  • Calculation of preoperative and postoperative GNRI values and analysis of laboratory data.
  • Patients were categorized based on thrombosis history and GNRI scores (G0-G3).

Main Results:

  • Preoperative GNRI was significantly higher in patients without fistula thrombosis.
  • Fistula patency duration showed a positive correlation with preoperative GNRI.
  • Lower GNRI scores (e.g., G3) were associated with shorter patency durations compared to higher scores (e.g., G0).

Conclusions:

  • Malnutrition, as indicated by GNRI, is strongly associated with arteriovenous fistula patency in hemodialysis patients.
  • Preoperative nutritional assessment using GNRI may aid in predicting and managing fistula patency.
  • Identifying and addressing malnutrition before fistula surgery could enhance long-term vascular access outcomes.