ArticleBMC nephrology2026
Nutritional Risk Index for Japanese Hemodialysis Patients, protein-energy wasting, and mortality associations in patients undergoing hemodialysis.
Article in BMC 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
backgroundThe associations between the Nutritional Risk Index for Japanese Hemodialysis Patients (NRI-JH) score, protein-energy wasting (PEW), and mortality in patients undergoing hemodialysis remain unclear. We investigated the associations among the NRI-JH score, PEW, and all-cause death in patients undergoing hemodialysis.
methodsWe retrospectively enrolled 263 patients on maintenance hemodialysis for more than 6 months. PEW was diagnosed using the simple PEW score. We determined the optimal NRI-JH cutoff score for diagnosing PEW from the receiver operating characteristic curve analysis. We divided patients into two groups using the cutoff and followed up on mortality.
resultsThe NRI-JH score and simple PEW score were significantly correlated (ρ = 0.581, p < 0.0001). The NRI-JH scores were notably higher for patients with PEW (median 8 [interquartile range (IQR) 5–9], N = 94) than for those without PEW (median 4 [IQR 1–7], N = 169) (p < 0.0001). The optimal NRI-JH score cutoff was 8 (area under the curve 0.776, sensitivity 0.617, specificity 0.841; p < 0.0001). During the follow-up period, 131 patients died. The 5-year survival rate was significantly lower in the group with NRI-JH scores ≥ 8 than in the group with scores < 8 (43.4% vs. 75.7%; p < 0.0001). A higher NRI-JH score was independently linked to an increased all-cause mortality risk (adjusted hazard ratio 1.98, 95% confidence interval 1.34–2.93; p = 0.0007). Moreover, adding the NRI-JH score to the baseline risk model significantly improved the net reclassification improvement (0.418, p = 0.00051).
conclusionsThe optimal NRI-JH cutoff for diagnosing PEW in Japanese patients on hemodialysis was 8. Additionally, a higher NRI-JH score (≥ 8) was independently associated with a greater risk of all-cause mortality. Therefore, the NRI-JH may serve as both a marker of malnutrition and a predictor of mortality in these patients.
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