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

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
• malnutrition
• assessment
• peritoneal dialysis
• prognosis

Acknowledgement

The authors of this study would like to thank the patients who contributed to the data in the article.

Ethical approval and consent to participate

This study was conducted in compliance with the ethical standards of the Declaration of Helsinki and authorized by the Medical Research Ethics Committee of the Jiujiang First People’s Hospital(jjsdyrmyy-yxyj-2021-107). And the Medical Research Ethics Committee of Jiujiang First People’s Hospital waived the informed consent procedure due to the noninvasive and anonymous.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All available data have been presented in the paper.

Additional information

Funding

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