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营养状况可预测未透析慢性肾脏病患者血管钙化的严重程度。

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

作者信息

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

机构信息

Department of Cardiology, Nagoya University Graduate School of Medicine.

出版信息

Circ J. 2017 Feb 24;81(3):316-321. doi: 10.1253/circj.CJ-16-0911. Epub 2017 Jan 12.

DOI:10.1253/circj.CJ-16-0911

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.

摘要

背景

血管钙化是慢性肾脏病（CKD）的主要并发症，会增加不良临床结局的风险。老年营养风险指数（GNRI）是一种简单的营养评估工具，可预测老年患者的不良预后。本研究旨在评估非透析CKD患者中GNRI与血管钙化严重程度之间的相关性。

方法与结果

我们纳入了323例无症状CKD患者。为评估腹主动脉钙化（AAC），我们使用了在非增强计算机断层扫描上测定的主动脉钙化指数（ACI）。根据GNRI三分位数将患者分为三组。随着GNRI三分位数的增加，中位数ACI显著降低（分别为15.5%、13.6%和7.9%；P = 0.001）。多因素回归分析显示GNRI与ACI显著相关（β = -0.15，P = 0.009）。我们还研究了GNRI与C反应蛋白（CRP）联合用于预测AAC严重程度的情况。与高GNRI和低CRP相比，低GNRI和高CRP与严重AAC显著相关（OR，4.07；P = 0.004）。