Nutrition Status Predicts Severity of Vascular Calcification in Non-Dialyzed Chronic Kidney Disease.

Kazuhiro Harada, Susumu Suzuki, Hideki Ishii, Kenshi Hirayama, Toshijiro Aoki, Yohei Shibata, Yosuke Negishi, Takuya Sumi, Kazuhiro Kawashima, Ayako Kunimura, Yosuke Tatami, Toshiki Kawamiya, Dai Yamamoto, Ryota Morimoto, Yoshinari Yasuda, Toyoaki Murohara

Journal: Circulation journal : official journal of the Japanese Circulation Society 2017;81(3):316-321

PMID: 28077811

Abstract

BACKGROUND

Vascular calcification is a major complication in chronic kidney disease (CKD) that increases the risk of adverse clinical outcomes. Geriatric nutritional risk index (GNRI) is a simple nutritional assessment tool that predicts poor prognosis in elderly subjects. The purpose of the present study was to evaluate the correlation between GNRI and severity of vascular calcification in non-dialyzed CKD patients.

METHODS AND RESULTS

We enrolled 323 asymptomatic CKD patients. To evaluate abdominal aortic calcification (AAC), we used aortic calcification index (ACI) determined on non-contrast computed tomography. The patients were divided into three groups according to GNRI tertile. Median ACI significantly decreased with increasing GNRI tertile (15.5%, 13.6%, and 7.9%, respectively; P=0.001). On multivariate regression analysis GNRI was significantly correlated with ACI (β=-0.15, P=0.009). We also investigated the combination of GNRI and C-reactive-protein (CRP) for predicting the severity of AAC. Low GNRI and high CRP were significantly associated with severe AAC, compared with high GNRI and low CRP (OR, 4.07; P=0.004).

CONCLUSIONS

GNRI was significantly associated with AAC in non-dialyzed CKD patients.

Address: Department of Cardiology, Nagoya University Graduate School of Medicine.
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