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

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 sco...

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Autores principales: Takagi, Kimiaki, Takahashi, Hiroshi, Miura, Tomomi, Yamagiwa, Kasumi, Kawase, Kota, Muramatsu-Maekawa, Yuka, Koie, Takuya, Mizuno, Masashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9182995/
https://www.ncbi.nlm.nih.gov/pubmed/35684116
http://dx.doi.org/10.3390/nu14112317
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author Takagi, Kimiaki
Takahashi, Hiroshi
Miura, Tomomi
Yamagiwa, Kasumi
Kawase, Kota
Muramatsu-Maekawa, Yuka
Koie, Takuya
Mizuno, Masashi
author_facet Takagi, Kimiaki
Takahashi, Hiroshi
Miura, Tomomi
Yamagiwa, Kasumi
Kawase, Kota
Muramatsu-Maekawa, Yuka
Koie, Takuya
Mizuno, Masashi
author_sort Takagi, Kimiaki
collection PubMed
description 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 (β = 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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spelling pubmed-91829952022-06-10 Prognostic Value of the Controlling Nutritional Status (CONUT) Score in Patients at Dialysis Initiation Takagi, Kimiaki Takahashi, Hiroshi Miura, Tomomi Yamagiwa, Kasumi Kawase, Kota Muramatsu-Maekawa, Yuka Koie, Takuya Mizuno, Masashi Nutrients Article 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 (β = 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. MDPI 2022-05-31 /pmc/articles/PMC9182995/ /pubmed/35684116 http://dx.doi.org/10.3390/nu14112317 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Takagi, Kimiaki
Takahashi, Hiroshi
Miura, Tomomi
Yamagiwa, Kasumi
Kawase, Kota
Muramatsu-Maekawa, Yuka
Koie, Takuya
Mizuno, Masashi
Prognostic Value of the Controlling Nutritional Status (CONUT) Score in Patients at Dialysis Initiation
title Prognostic Value of the Controlling Nutritional Status (CONUT) Score in Patients at Dialysis Initiation
title_full Prognostic Value of the Controlling Nutritional Status (CONUT) Score in Patients at Dialysis Initiation
title_fullStr Prognostic Value of the Controlling Nutritional Status (CONUT) Score in Patients at Dialysis Initiation
title_full_unstemmed Prognostic Value of the Controlling Nutritional Status (CONUT) Score in Patients at Dialysis Initiation
title_short Prognostic Value of the Controlling Nutritional Status (CONUT) Score in Patients at Dialysis Initiation
title_sort prognostic value of the controlling nutritional status (conut) score in patients at dialysis initiation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9182995/
https://www.ncbi.nlm.nih.gov/pubmed/35684116
http://dx.doi.org/10.3390/nu14112317
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