The Impact of a Major Earthquake on Nutritional Status and Survival in Hemodialysis Patients: A Retrospective Observational Study

IF 4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition Pub Date : 2026-05-01 Epub Date: 2025-12-04 DOI:10.1053/j.jrn.2025.09.005

Sibel Ada MD , Tayfur Toptas MD

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引用次数: 0

Abstract

Objectives

Malnutrition increases the risk of mortality in hemodialysis (HD) patients. The Geriatric Nutritional Risk Index (GNRI) is a robust tool that predicts mortality in HD patients, with changes in GNRI linked to survival. Our objective was to evaluate the impact of the 2011 Van earthquake on the nutritional status and short- and long-term survival of HD patients.

Methods

This study was conducted in 2011-2012 across five dialysis centers in Van, Turkey. Patients aged ≥18 years, undergoing HD thrice weekly, and residing in the earthquake area for at least 1 year before and after the earthquake were included. Nutritional data were collected 1 month before the earthquake and at 1-, 6-, and 12-month postearthquake. The long-term impact of GNRI on survival was assessed, with a data cutoff date of December 2024, allowing for a follow-up period of up to 13 years postearthquakefor survival outcomes.

Results

Nutritional parameters, including systolic/diastolic blood pressure, body mass index, hemoglobin, serum phosphate, serum triglycerides, postdialysis weight, and GNRI, showed changes after the earthquake, primarily a decrease. The largest changes were observed in systolic/diastolic blood pressures and serum phosphate (effect sizes: −0.47, −0.43, and −0.38, respectively). Patients with GNRI <90 increased from 13.4% pre-earthquake to 17.9% at 1 month but decreased to 11.7% by 6 months, indicating a transient impact. Importantly, a pre-earthquake GNRI <90 was associated with a worse prognosis (hazard ratio: 1.71, 95% CI confidence interval: 1.06-2.76, P = .03) in univariate analysis. In multivariate analyses, over 13 years, GNRI <90 was associated with a 78% higher mortality risk (hazard ratio: 1.78, 95% confidence interval: 1.33-2.90, P = .02), indicating its significance as a long-term predictor.

Conclusions

The impact of a major earthquake on short-term nutritional parameters was minimal and transient, with no observed direct impact on short-term survival. Long-term malnutrition, as assessed by the GNRI, is a significant predictor of long-term mortality, and its predictive capacity remained unaffected by the earthquake.

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查看原文本刊更多论文

大地震对血液透析患者营养状况和生存的影响：一项回顾性观察研究。

背景与假设：营养不良会增加血液透析（HD）患者的死亡风险。老年营养风险指数（GNRI）是预测HD患者死亡率的有力工具，GNRI的变化与生存有关。我们的目的是评估2011年Van地震对HD患者营养状况和短期和长期生存的影响。方法：本研究于2011-2012年在......的五个透析中心进行患者年龄≥18岁，每周接受3次HD治疗，在地震前后居住在震区至少1年。在地震前1个月和震后1、6、12个月收集营养数据。评估了GNRI对生存的长期影响，数据截止日期为2024年12月，允许震后长达13年的生存结果随访期。结果：地震后患者的收缩压/舒张压、体重指数、血红蛋白、血清磷酸盐、血清甘油三酯、透析后体重、GNRI等营养指标均有变化，以下降为主。收缩压/舒张压和血清磷酸盐变化最大（效应值分别为-0.47,-0.43,-0.38）。结论：大地震对短期营养参数的影响很小且是短暂的，对短期生存没有直接影响。根据GNRI的评估，长期营养不良是长期死亡率的重要预测指标，其预测能力并未受到地震的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Renal Nutrition 医学-泌尿学与肾脏学

CiteScore

5.70

自引率

12.50%

发文量

146

审稿时长

6.7 weeks

期刊介绍： The Journal of Renal Nutrition is devoted exclusively to renal nutrition science and renal dietetics. Its content is appropriate for nutritionists, physicians and researchers working in nephrology. Each issue contains a state-of-the-art review, original research, articles on the clinical management and education of patients, a current literature review, and nutritional analysis of food products that have clinical relevance.