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논문분류	춘계학술대회 초록집
제목	Prognostic impact of prognostic nutrition index and controlling nutritional status score on long-term outcomes in older patients with incident hemodialysis
저자	Yu Ah Hong
출판정보	2023; 2023(1):
키워드
초록	Objectives: The prognostic nutritional index (PNI) and the controlling nutritional status (CONUT) score reflect the immune-nutritional status and were recently knwon as novel prognostic factors of various diseases. We aimed to examine the prognostic value of these indexes on long-term outcomes in older patients with incident hemodialysis. Methods: The incident dialysis patients aged ≥70years who can calculate PNI and CONUT score were enrolled from a retrospective cohort from the Korean Society of Geriatric Nephrology. The patients was categorized as four groups according to PNI (PNI ≥50, 45≤ PNI<50, 40≤PNI<45, PNI<40) and CONUT score (0-1, 2-4, 5-8, 9-12). Results: A total of 883 subjects were enrolled and 253 patients (28.7 %) died during follow up period of 1,218 days. Lower PNI group and higher CONUT group were significantly related to more male sex, lower presence of vascular access at dialysis initiation, higher prevalence of dementia and congestive heart failure, lower mobility, more hospitalization within 6 months at dialysis initiation, lower Hb level, higher neutrophil/lymphocyte ratio, lower sodium, lower albumin and lower total cholesterol level. All-cause mortality was markedly higher in patients with lower PNI group and higher CONUT score than in the patients with highest PNI group and lowest CONUT group (P < 0.001 and P < 0.001, by log-rank test). The HR for all-cause mortality in a crude model of patients with lowest NPI and highest CONUT score was 2.31 (95% CI, 1.60-3.35; P < 0.001), and 3.02 (95% CI, 2.01-4.52; P < 0.001) Multivariate Cox regression analysis revealed that lowest PNI remained at higher risk for all-cause mortality (HR, 2.44; 95% CI, 1.52-3.90; P < 0.001), but highest CONUT score did not show a statistical significance after adjusting for confounding variables. Conclusions: PNI is a more reliable prognostic factor on long-term all-cause mortality than CONUT score in elderly patients with incident dialysis.
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