Abstract: Objective To explore the effect of stratified dietary intervention based on geriatric nutritional risk index (GNRI) on nutritional status and self-efficacy in elderly patients with continuous hemodialysis
(MHD). Methods A total of 60 elderly MHD patients treated in The Second Affiliated Hospital of Nanjing
Medical University from January 2020 to January 2021 were randomly selected and divided into an intervention group (n=30) and a control group (n=30) by random number table method. The control group implemented conventional intervention measures, and the intervention group implemented GNRI stratified dietary intervention in addition to the conventional intervention measures. The changes of nutritional status after 3 months
of the interventions, including the score of subjective global assessment (scored patient-generated subjective
global assessment, PG-SGA score), body mass index (body mass index, BMI), triceps skin triceps skin fold
(TSF), self- efficacy (general self- efficacy scale score, GSES score), dietary treatment attitude (the attitude
scale for the dietary therapy of hemodialysis patients, ASDTH score), and quality of life (kidney disease quality of life short form score, KDQ score) were compared between the two groups. Results After 3 months of
the interventions, PG-SGA score, BMI, TSF, event coping, goal achievement and individual problem solving,
ASDTH score and KDQ score were higher in the intervention group than in the control group (t=5.450,
- 2.199, - 3.510, - 5.122, - 5.142, - 5.085, - 4.280 and - 4.959, respectively; P<0.001, =0.032, =0.001, <0.001,
<0.001, =0.001, <0.001 and <0.001, respectively). Conclusion GNRI stratified dietary intervention can improve the nutritional status, self- efficacy, diet therapy attitude and quality of life in elderly MHD patients,
highlighting its value in clinical application.

Key words: Geriatric nutritional risk index, Stratified diet intervention, Maintenance hemodialysis, Nutritional status, Self-efficacy