ArticleInternational urology and nephrology2026
Nutritional predictors of one-year survival in hemodialysis patients: insights from a cohort analysis.
Article in International urology and nephrology, 2026. 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
backgroundProtein-energy wasting is linked to adverse outcomes in dialysis. The independent prognostic value of pragmatic nutritional indicators under strong age confounding warrants clarification.
methodsRetrospective single-center cohort of adults on thrice-weekly high-flux hemodialysis. PRIMARY ENDPOINT: all-cause 1-year mortality. Primary analysis used multivariable logistic regression on the full cohort (N = 416) with age (continuous) and sex adjustment. Prespecified sensitivity analyses included age stratification (< 75 vs ≥ 75 years) and an age × GNRI interaction. Matched comparisons (± 1-year nearest neighbor, 1:1) are provided in the Supplement. Calibration (Brier score, calibration plot), discrimination (AUC), and incremental value metrics (ΔAUC, IDI/NRI) were computed.
resultsIn the full cohort, deaths at 1 year were 59/416 (14.2%). In multivariable models, GNRI was inversely associated with mortality (OR per 1-point 0.97; 95% CI 0.94-0.99; p = 0.010), while age increased risk (OR per year 1.06; 95% CI 1.03-1.09; p < 0.001). The AUC improved from 0.706 (age + sex) to 0.714 (age + sex + GNRI); IDI 0.030 and continuous NRI 0.301 indicated incremental predictive gain. The model showed reasonable calibration (Brier ≈ 0.103). In age-stratified analyses, the GNRI association was significant in subjects ≥ 75 years (OR 0.94; 95% CI 0.91-0.97; p < 0.001) but not in < 75 years, with a significant age × GNRI interaction (p = 0.011).
conclusionsUnder routine data availability, GNRI provides independent, clinically implementable prognostic information-especially in older hemodialysis patients-supporting its use in pragmatic risk stratification.
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