Relationship between Geriatric Nutritional Risk Index and total lymphocyte count and mortality of hemodialysis patients.

We examined the relationships between Geriatric Nutritional Risk Index (GNRI), total lymphocyte count (TLC), and mortality in hemodialysis (HD) patients. We examined GNRI and TLC in 120 maintenance HD patients and followed these patients for 120 months. Predictors of all-cause death were examined using life table analysis and the Cox proportional hazards model. TLC marginally correlated with GNRI (r = 0.176; p = 0.090) and significantly with phosphorus levels (r = 0.206; p = 0.026). Life table analysis revealed that subjects with a GNRI < 90 (n = 19) had lower survival rates than did those with a GNRI ≥ 90 (n = 101; Wilcoxon's test, p = 0.048), but subjects with a TLC < 1500/mm(3) (n = 76) had similar survival rates compared with subjects with a TLC ≥ 1500/mm(3) (n = 44; Wilcoxon's test, p = 0.500). Multivariate Cox proportional hazards analyses demonstrated that GNRI is a significant predictor of mortality (hazard ratio 9.315, 95% confidence interval 1.161-74.753, p = 0.036), after adjusting for age, sex, presence of type 2 diabetes mellitus, Kt/V, normalized protein catabolic rate, hematocrit, phosphorus, systolic blood pressure and TLC. Our findings suggest the TLC may be used as a simple nutritional tool, but may not be a predictor of mortality in HD patients. These findings require confirmation by further studies.

Cardiac involvement in hypereosinophilia associated with toxocariasis.

Cardiac involvement in hypereosinophilia is rare; when present, it manifests as ventricular thickening, usually with fibrous tissue and mural thrombosis. We present a case of a 57-year-old man with an abnormal right ventricular apex with eosinophilia, which was caused by Toxocara canis infection.