Geriatric Nutritional Risk Index, a Simplified Nutritional Screening Index, Is a Strong Predictor of Handgrip Strength in Renal Transplant Recipients

• Published in: Transplantation proceedings 2018-10, Vol.50 (8), p.2509-2514
• Main Authors: Lin, I.-H., Wong, T.-C., Nien, S.-W., Wang, H.-H., Chiang, Y.-J., Yang, S.-H.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Geriatric Assessment - methods; Hand Strength; Humans; Kidney Transplantation; Male; Middle Aged; Nutrition Assessment; Nutritional Status; Predictive Value of Tests
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2018.03.085

The Geriatric Nutritional Risk Index (GNRI) is a useful predictor of prognosis in older patients and those receiving hemodialysis. However, the predictive value of the GNRI in renal transplant recipients (RTRs) is unclear. In this study we investigated the correlation between the GNRI and muscle function, as indicated by handgrip strength (HGS). A cross-sectional study was performed on 42 RTRs (50% women), with a mean age of 49.0 ± 10.8 years. The GNRI was derived from patients' body weight and serum albumin level by using the following equation: GNRI = [14.89 × albumin (g/dL)] + [41.7 × (body weight/ideal body weight)]. HGS was evaluated in dominant arms; HGS measurement was repeated 3 times, and the highest value was used. Multivariable stepwise regression analyses were performed to obtain adjusted correlates, and the significance levels for entry and remaining were set at 0.1. The mean values of the GNRI and HGS were 105.0 ± 5.4 and 29.0 ± 9.4, respectively. The GNRI was positively correlated with HGS (r = 0.36, P = .02). Linear and stepwise multivariable adjustment analyses revealed that the homeostatic model assessment of insulin resistance (HOMA-IR) and GNRI were independent determinants of HGS (βHOMA-IR = 0.53 and βGNRI = 0.43, adjusted R2 = 0.45) after adjustment for age, sex, total muscle mass, and C-reactive protein level as covariates. This study has shown that the GNRI is a favorable predictor of muscle function in RTRs. •The Geriatric Nutritional Risk Index (GNRI) is a strong predictor of handgrip strength in renal transplantation recipients.•The GNRI can be used as an objective tool for assessment of nutritional status and muscle strength.•Physiologic and pathophysiologic changes show the relationship between nutritional status and sarcopenia.