ArticleKidney medicine2025
Preoperative Geriatric Nutritional Risk Index Score as a Novel Predictor of Postoperative Acute Kidney Injury in Noncardiac Surgery: The NARA-AKI Cohort Study.
Article in Kidney medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Rationale & Objective: Malnutrition could be a risk factor for postoperative acute kidney injury (AKI). The geriatric nutritional risk index (GNRI) is a simple indicator of malnutrition, and this study examined the association of preoperative GNRI with postoperative AKI in noncardiac surgery. Study Design: A retrospective cohort study. Setting & Population: Adults who underwent noncardiac surgery under general anesthesia from 2007-2011 were included. Obstetric or urologic surgery, missing serum creatinine, baseline estimated glomerular filtration rate <15 mL/min/1.73 m Predictor: Preoperative GNRI. Outcome: AKI within 7 days after surgery. Analytical Approach: Multivariable logistic regression and restricted cubic spline analysis were performed to examine the association of preoperative GNRI with AKI. Results: Among 5,148 patients, 301 (5.8%) developed AKI. After adjustment for potential confounders, preoperative lower GNRI scores were independently associated with higher incidence of postoperative AKI (adjusted OR [95% confidence interval], 1.20 [0.84-1.73], 1.37 [0.91-2.06], and 1.88 [1.11-3.20] for those with mild [92 ≤ GNRI < 98], moderate [82≤ GNRI <92], and severe [GNRI <82] malnutrition, respectively ( Limitations: The presence of residual unknown confounders is a concern although a maximal effort was made to adjust for possible confounders. Conclusions: Lower GNRIs were independently associated with postoperative AKI irrespective of patients' age, malignancy, or inflammation. Improvement of preoperative malnutrition may reduce postoperative AKI.
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