A NEW study has shown that combining two simple clinical measurements, the Geriatric Nutritional Risk Index (GNRI) and the Modified Creatinine Index (mCI), can significantly improve the ability to predict functional dependence in patients undergoing maintenance haemodialysis (MHD).
The study included 208 patients treated at the Second Affiliated Hospital of Soochow University between June and December 2023. Researchers evaluated patients’ ability to live independently using well-established tools: the Katz Index for basic activities of daily living and the Lawton-Brod scale for instrumental activities.
More than half of the participants (52.9%) were classified as functionally dependent. These individuals were generally older and more likely to have diabetes, higher pulse pressure, and lower blood levels of creatinine, albumin, and cholesterol, markers closely tied to nutrition and muscle mass.
When GNRI and mCI were used separately, they provided moderate predictive power for functional decline, with area under the curve (AUC) scores of 0.657 and 0.682, respectively. However, when combined, the AUC rose to 0.708, indicating a stronger and more accurate prediction model.
“These findings suggest that integrating nutritional and muscle health assessments offers a more comprehensive view of a patient’s risk for losing independence,” the authors noted.
The study highlights a crucial need to monitor functional capacity in dialysis patients, an often-overlooked component of health that directly affects quality of life, treatment adherence, and hospitalisation risk.
With further validation, this combined index approach could help nephrologists and care teams better identify at-risk patients early and implement timely interventions to preserve independence and improve long-term outcomes.
Aleksandra Zurowska, EMJ
Reference
Ni R et al. Combined evaluation of geriatric nutritional risk index and modified creatinine index for predicting functional dependence in patients on Hemodialysis. BMC Nephrol. 2025;DOI: 10.1186/s12882-025-04132-0.
