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The following is a summary of “Impact of the Geriatric Nutritional Risk Index on short-term prognosis of patients with sepsis-related acute kidney injury: analysis using the MIMIC-IV database,” published in the April 2025 issue of BMC Nephrology by Cai et al. 

Malnutrition is common in critically ill elderly patients, affecting outcomes. The Geriatric Nutritional Risk Index (GNRI) helps assess nutritional status, but its relationship with sepsis-related acute kidney injury (S-AKI) remains unclear. 

Researchers conducted a retrospective study to explore the relationship between the GNRI and S-AKI in critically ill elderly patients.  

They sourced patient data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and divided patients into 4 groups based on their GNRI score using quartile analysis. The main objective was to investigate the 28-day mortality rate, with secondary outcomes including the incidence of severe AKI, ICU length of stay, and days in the hospital. A Cox proportional hazards regression model and restricted cubic splines were used to evaluate the association between GNRI score and study outcomes, while Kaplan–Meier curves compared the outcomes in each group. 

The results showed that 4,515 elderly patients with S-AKI were included. Patients were categorized into 4 GNRI groups: Q1 (<78.92), Q2 (78.92–84.88), Q3 (84.88–90.84), and Q4 (>90.84). The overall 28-day mortality was 29.5%. Patients with low GNRI were predominantly women with a low BMI. After adjusting for confounders, GNRI score was an independent predictor of 28-day mortality (Q4 vs. Q1: hazard ratio (HR) 0.74, 95% CI 0.63–0.87; P<0.001). Restricted cubic spline analysis showed a linear relationship between GNRI and 28-day mortality (P for non-linearity = 0.207), consistent across all subgroups. 

Investigators found that the GNRI was an important nutritional assessment tool and useful in predicting the prognosis of critically ill elderly patients with S-AKI. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-025-04122-2