Abstract: 【Abstract】Objective As a common nutritional risk screening tool, the Geriatric Nutritional Risk Index (GNRI) has been used to assess nutritional status under various pathological conditions. We evaluated the correlation between GNRI and the prognosis of maintenance hemodialysis patients by a systematic review and meta-analysis. Methods Relevant articles were collected by searching web of science, PubMed, EMBASE, Cochrane Library, CNKI and Wanfang medical database. The outcomes were all-cause mortality, cardiovascular mortality and cardiovascular events in maintenance hemodialysis patients. The deadline for the search was November 2020. Use Review Manager 5.3 to pool hazard ratio (HR) and 95% confidence interval (CI) and other related information. Results A total of 20 studies involving 10162 patients were included. The results of meta-analysis showed that the GNRI (as continuous variable) had statistical significance with all-cause mortality risk and cardiovascular mortality of maintenance hemodialysis patients, but no statistical significance with cardiovascular events (HR=0.96, 95% CI：0.94～0.98, P< 0.001; HR=0.94, 95%CI：0.91～0.98, P< 0.001); (HR=0.96, 95% CI：0.86～1.08, P＝0.510). As a binary variable, GNRI had statistical significance with allcause mortality and cardiovascular mortality in maintenance hemodialysis patients (HR=2.13, 95% CI：1.84～2.46, P < 0.001) and (HR=2.00, 95% CI：1.04～3.88, P=0.040). Conclusion GNRI is related to all-cause mortality and cardiovascular mortality in maintenance hemodialysis patients. GNRI can be used as a predictor of adverse outcomes in maintenance hemodialysis patients.

Key words: Elderly nutritional risk index, Hemodialysis, All-cause mortality, Cardiovascular mortality, Cardiovascular events, Meta-analysis