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Updated: Sep 10, 2025

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
Published on: May 2, 2025
Geriatric nutritional risk index predicts incident kidney failure with replacement therapy among patients with
Takayuki Uemura1, Masatoshi Nishimoto1, Masahiro Eriguchi1
1Department of Nephrology, Nara Medical University, Nara, Japan.
Aims:
The geriatric nutritional risk index (GNRI) is a predictor for kidney prognosis. However, malnutrition can lead to overestimation of creatinine-based estimated glomerular filtration rate (eGFR), particularly in diabetic nephropathy (DN). This study examined whether GNRI was associated with kidney prognosis after accounting for muscle mass-independent kidney function markers in DN.
Methods:
This observational study included patients with biopsy-proven DN at Nara Medical University Hospital. The exposure was GNRI at the time of kidney biopsy. The outcome was kidney failure with replacement therapy (KFRT). Multivariable Cox regression analyses were performed to examine the association of GNRI with KFRT.
Results:
Among 405 patients were categorized by GNRI cutoff of 98. During a median follow-up of 6.7 years, 99 patients developed KFRT. Lower GNRI was associated with higher incidence of KFRT after adjustment for clinical and kidney histopathological factors (hazard ratio [95 % confidence interval]: 3.13 [1.74-5.61]). The association remained robust even after additional adjustment for muscle mass-independent kidney function markers (serum β2-microglobulin or muscle mass-adjusted eGFR).
Conclusions:
Among patients with DN, lower GNRI was associated with incident KFRT even after adjustment for muscle mass-independent kidney function markers. Further research is warranted to clarify whether nutritional improvement can attenuate kidney function decline.
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