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

• Published in: Circulation Journal Vol. 81; no. 3; pp. 316 - 321
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2017
• Subjects: Aged; Aorta, Abdominal - diagnostic imaging; Aortic calcification index; Aortography; C-Reactive Protein - metabolism; Female; Geriatric nutritional risk index; Humans; Male; Middle Aged; Nutrition status; Nutritional Status; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnostic imaging; Severity of Illness Index; Vascular Calcification - blood; Vascular Calcification - diagnostic imaging; Vascular Calcification - etiology
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-16-0911

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.