Multiple factors influencing mortality in hemodialysis patients

OBJECTIVE: Both decreased food intake and elevated inflammation contrib-ute to malnutrition in hemodialysis (HD) pa-tients. Malnutrition, inflammation, anthropomet-ric measurements, and other comorbidity fac-tors were investigated in this study as potential indicators of mortality in HD patients.PATIENTS AND METHODS: By measuring geriatric nutritional risk index (GNRI), malnu-trition inflammation score (MIS), and prognos-tic nutritional index (PNI), 334 HD patients' nu-tritional status was assessed. Through the use of four different models and logistic regression analysis, the predictors of each individual's sur-vival status were examined. The models were matched using the Hosmer-Lemeshow test. On the survival of patients, the effects of malnutri-tion indices in Model 1, anthropometric mea-surements in Model 2, blood parameters in Mod-el 3, and sociodemographic characteristics in Model 4 were investigated.RESULTS: Five years later, 286 individuals were still on hemodialysis. Patients who had a high GNRI value had a lower mortality rate in Model 1. The body mass index (BMI) value of the patients was found to be the best predictor of mortality in Model 2, and it was found that pa-tients with high muscle percentage had a lower mortality risk. The difference in urea level mea-sured at the beginning and end of hemodialy-sis was found to be the most potent predictor of mortality in Model 3, although C-reactive pro-tein (CRP) level was also discovered to be one of the best predictors for this model. The final model, Model 4, revealed that mortality was low-er in women than in men and that income status was a reliable predictor of mortality estimation.CONCLUSIONS: The best indicator of mor-tality in hemodialysis patients is the malnutri-tion index.