10.1159/000503210

Vollständiger Abstract

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Older adults (OA) exhibit the highest incidence of acute kidney injury (AKI), with outcomes influenced by comorbidities, frailty, and malnutrition. Nutritional status, a potentially modifiable factor, has not been extensively evaluated as a mortality predictor in hospitalized OA with AKI. Our purpose was to report on the mortality risk provided by the nutritional status, comorbidities, and biochemical parameters in OA with AKI.<h4>Methods</h4>In this prospective cohort study (July 2024-July 2025) conducted at a tertiary geriatric unit, hospitalized OA with AKI, diagnosed according to KDIGO criteria, underwent a comprehensive nutritional assessment within 48 hours of admission. The Geriatric Nutritional Risk Index (GNRI), Mini Nutritional Assessment, anthropometric measurements, and biochemical markers were recorded. The primary outcome was in-hospital all-cause mortality; secondary outcomes included the analysis of all-cause mortality according to nutritional and clinical factors, such as dysphagia, hyporexia, and GNRI quartiles (Q1-Q4). Logistic regression models were used to identify independent predictors of mortality, and all models were adjusted for AKI severity.<h4>Results</h4>Of 742 admissions, 187 patients met the inclusion criteria. The median age was 76.8 years, and 50% were male. GNRI quartile analysis demonstrated a progressive deterioration in anthropometric and biochemical markers from Q4 to Q1. Mortality was higher in the high-risk GNRI group (42.2% vs 30.1%); however, this difference did not reach statistical significance (p = 0.098). In adjusted analyses, dysphagia (adjusted odds ratio [aOR] 6.11; 95% CI 1.82-20.51; p = 0.003), hyporexia (aOR 2.24; 95% CI 1.02-4.92; p = 0.044), and lower GNRI (aOR 1.07 per unit decrease; 95% CI 1.02-1.13; p = 0.004) were independently associated with increased mortality. In contrast, a higher mid-upper arm circumference was independently associated with a protective effect (aOR 0.78; 95% CI 0.67-0.91; p = 0.001).<h4>Conclusions</h4>In OA hospitalized with AKI, poor nutritional status, particularly dysphagia, hyporexia, and lower GNRI, was independently associated with increased in-hospital mortality, whereas preserved muscle mass was protective. Early, simple, bedside nutritional assessments may help guide targeted interventions to improve outcomes in this high-risk population.

Abstract: PubMed · Datensatz