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

被引：21

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

来源：

NUTRIENTS | 2022年 / 14卷 / 11期

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.

引用

页数：11

共 32 条

[11] A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease [J].