GLIM criteria for definition of malnutrition in peritoneal dialysis: a new aspect of nutritional assessment

Ren Fail. 2024 Dec;46(1):2337290. doi: 10.1080/0886022X.2024.2337290. Epub 2024 Apr 4.

Abstract

Background: The aim of our study was to evaluate the effectiveness of Global Leadership Initiative on Malnutrition (GLIM) criteria in assessing malnutrition within the peritoneal dialysis (PD) population.Methods: We conducted a retrospective analysis involving 1057 PD patients across multiple institutions, characterized by an age of 56.1 ± 14.4 years, 464 (43.9%) female, and a median follow-up of 45 (25, 68) months. Malnutrition was diagnosed according to GLIM criteria. The endpoint event was overall mortality. The survival rate and hazard ratio (HR) of death between malnutrition and well-nourished were analyzed in all patients and various subgroups. Receiver operator characteristic curve and integrated discrimination improvement (IDI) were used to distinguish the efficacy of the nutritional tools prediction model.Results: According to the GLIM criteria, the prevalence of malnutrition among the study population was 34.9%. The adjusted HR of overall mortality was 2.91 (2.39 - 3.54, p < 0.001) for malnutrition versus well-nourished. In sensitivity analyses, the HR remained robust except the cardiovascular disease subgroup. The area under the curve of GLIM predicting 5-year mortality was 0.65 (0.62-0.68, p < 0.001). As a complex model for forecast the long-term mortality, the performance of adjusted factors combined with GLIM was poorer than combined malnutrition inflammation score (MIS) (IDI >0, p < 0.001), but fitter than combined geriatric nutritional risk index (GNRI) (IDI <0, p < 0.001).Conclusions: The GLIM criteria provide a viable tool for nutritional assessment in patients with PD, and malnutrition defined according to the GLIM can predict prognosis with an acceptable performance.

Keywords: GLIM; assessment; malnutrition; peritoneal dialysis; prognosis.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Leadership
  • Male
  • Malnutrition* / diagnosis
  • Malnutrition* / epidemiology
  • Malnutrition* / etiology
  • Middle Aged
  • Nutrition Assessment
  • Nutritional Status
  • Peritoneal Dialysis* / adverse effects
  • Retrospective Studies

Grants and funding

The author(s) reported there is no funding associated with the work featured in this article.