老年营养风险指数对维护血液透析患者整体存活期的预测值
1Department of Nephrology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
Frontiers in nutrition
|October 24, 2025
概括
较低的老年营养风险指数 (GNRI) 评分预测维持血液透析 (MHD) 患者的整体存活率较差. 这种营养评估工具可以识别高风险个体,以改善长期结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 营养科学 营养科学
背景情况:
- 维持血液透析 (MHD) 患者面临复杂的健康挑战,营养状况显著影响长期结果.
- 老年营养风险指数 (GNRI) 是用于评估营养风险的工具,但其在MHD人群中的预测价值需要进一步调查.
研究的目的:
- 评估老年营养风险指数 (GNRI) 作为接受维护血液透析 (MHD) 的患者整体存活率的预测指标.
- 确定营养状况在MHD患者的长期预后中所扮演的角色,如GNRI所示.
主要方法:
- 一项回顾性队列研究,涉及2020-2024年395名MHD患者.
- 基于血清白蛋白和BMI计算GNRI,然后使用Kaplan-Meier和Cox回归模型进行生存分析.
- 使用接收机操作特征 (ROC) 曲线分析来评估GNRI的预测准确性.
主要成果:
- 较低的GNRI得分与MHD患者的整体存活率降低显著相关.
- GNRI独立预测了整体存活率,较低的得分表明死亡风险更高 (每单位减少的HR).
- ROC分析显示了GNRI的良好预测能力 (AUC=0.754),最佳切断值为93 (灵敏度78.2%,特异性68.5%).
结论:
- 老年营养风险指数 (GNRI) 是维护血液透析 (MHD) 患者整体生存的有价值和可靠的预测指标.
- 将GNRI整合到临床实践中可以帮助识别需要增强营养支持的高风险患者,从而有可能改善他们的长期预后.
相关概念视频
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
188
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
188
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
233
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
233
01:28Chronic Kidney Disease III: Interprofessional Care
335
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
335
01:15Drug Dosing: Geriatric Patients
222
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
222
01:25Peritoneal Dialysis III: Nursing Management
649
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
649
01:25Hemodialysis III: Nursing Management
733
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
733