Association between malnutrition and adverse renal outcomes in patients with type 2 diabetes.

Introduction: Nutritional management is crucial in patients with chronic kidney disease. Therefore, it is important to assess nutritional status and detect malnutrition, especially in patients with diabetes. However, there is currently a lack of evidence regarding the relationship between nutritional indices and renal function in patients with type 2 diabetes. This study investigated whether the geriatric nutritional risk index (GNRI) is related to renal prognosis in type 2 diabetes patients.

Materials and methods: The study included 946 type 2 diabetes patients enrolled in the Fukushima Cohort Study. The primary endpoint of this study was a renal event, defined as a combination of a 50% decline in eGFR from baseline and end-stage kidney disease. All-cause death and new cardiovascular events were also measured as secondary outcomes. The association between GNRI and these endpoints was assessed using Cox regression analysis.

Results: The median patient age was 66 years, 57% were men, the median eGFR was 67.9 mL/min/1.73 m², and the median GNRI was 100.0. Compared to patients in the highest GNRI tertile, patients in the lowest tertile had a significantly increased risk of the renal event (HR 5.15, 95% CI 2.51-10.6) and all-cause death (HR 2.30, 95% CI 1.20-4.42). A significant association was not observed between GNRI levels and cardiovascular events.

Conclusions: We observed an association between poor nutritional status, assessed by GNRI, and adverse outcomes in patients with type 2 diabetes. Nutritional status assessment has potential utility as a prognostic tool for individuals with type 2 diabetes.