The Association of Malnutrition With Chronic Kidney Disease in the Older Chinese Population With Hypertension: Evidence From the China H-type Hypertension Registry Study

Objective: Current evidence of the dose-response association between the geriatric nutritional risk index (GNRI) and chronic kidney disease (CKD) is limited. Hence, this study aimed to determine the association between GNRI and CKD in the elderly Chinese population with hypertension. Methods: Data were derived from the China H-type Hypertension Registry. A total of 9,897 elderly patients with hypertension were included in the cross-sectional analysis. GNRI was calculated using the serum albumin and weight loss and the specific formula was as follows: GNRI = [1.489 x serum albumin (g/L)] + [41.7 x (actual weight/ideal weight)]. The outcome of our study was CKD, which was defined as an estimated glomerular filtration rate value of <60 mL/minute/1.73 m(2). The association between the GNRI and CKD was analyzed using multivariate logistic regression. Results: The present study population was composed of 9,897 participants with an average age of 68.67 (6.10) years. In particular, it was consisted of 4,683 (47.32%) male and 5,214 (52.68%) female participants. Overall, there was a significantly negative association between GNRI and CKD prevalence (per 1 increment; adjusted odds ratio [OR], 0.96; 95% confidence interval [CI]: 0.95-0.97). In a fully adjusted model, compared with the participants in the highest group tertiles 3 (GNRI >= 112), the participants in group tertiles 1 (GNRI <106) and group tertiles 2 (GNRI >= 106 <= 112) increased the prevalence of CKD by 57% (OR 1.57, 95% CI: 1.28-1.93) and 5% (OR 1.05, 95% CI: 0.86-1.28), respectively. Moreover, similar results were observed when the GNRI was assessed as a categorical variable based on the clinical cutoff values. Conclusion: This cross-sectional analysis found a significant negative association between GNRI and CKD among the elderly Chinese adults with hypertension.