Prognostic Value of the Controlling Nutritional Status (CONUT) Score in Patients at Dialysis Initiation

被引:19
|
作者
Takagi, Kimiaki [1 ,2 ]
Takahashi, Hiroshi [3 ]
Miura, Tomomi [4 ]
Yamagiwa, Kasumi [4 ]
Kawase, Kota [2 ]
Muramatsu-Maekawa, Yuka [1 ,2 ]
Koie, Takuya [2 ]
Mizuno, Masashi [5 ]
机构
[1] Daiyukai Daiichi Hosp, Dept Urol, 1-6-12,Hagoromo, Ichinomiya 4910025, Japan
[2] Gifu Univ, Dept Urol, Grad Sch Med, 1-1 Yanagido, Gifu 5011193, Japan
[3] Fujita Hlth Univ, Dept Nephrol, Sch Med, Toyoake, Aichi 4701192, Japan
[4] Daiyukai Daiichi Hosp, Dept Nutr, 1-6-12,Hagoromo, Ichinomiya 4910025, Japan
[5] Nagoya Univ, Grad Sch Med, Renal Replacement Therapy, Div Nephrol, 65 Tsurumai Showa Ku, Nagoya, Aichi 1668550, Japan
关键词
protein-energy wasting; CONUT; chronic kidney disease; dialysis; mortality; nutritional assessment; MALNUTRITION; MORTALITY; INFLAMMATION; MORBIDITY; DECLINE;
D O I
10.3390/nu14112317
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Protein-energy wasting (PEW) is common in patients with chronic kidney disease (CKD), and affects their prognosis. The Controlling Nutritional Status (CONUT) score is a nutritional screening tool calculated using only blood test data. This study aimed to investigate the prognostic value of CONUT score in patients just initiating dialysis. A total of 311 CKD patients who stably initiated dialysis were enrolled. Only 27 (8.7%) patients were classified as having normal nutritional status. The CONUT score was also independently correlated with elevated C-reactive protein levels (beta = 0.485, p < 0.0001). During the median follow-up of 37 months, 100 patients (32.2%) died. The CONUT score was an independent predictor of all-cause mortality (adjusted hazard ratio 1.13, 95% confidence interval 1.04-1.22, p < 0.0024). As model discrimination, the addition of the CONUT score to a prediction model based on established risk factors significantly improved net reclassification improvement (0.285, p = 0.028) and integrated discrimination improvement (0.025, p = 0.023). The CONUT score might be a simplified surrogate marker of the PEW with clinical utility and could predict all-cause mortality, in addition to improving the predictability in CKD patients just initiating dialysis. The CONUT score also could predict infectious-disease mortality.
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页数:11
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