Abstract: SA-PO389
The Prognostic Value of Objective Nutritional Scores in Patients Undergoing Maintenance Hemodialysis
Session Information
- Hemodialysis and Frequent Dialysis: CV and Risk Prediction
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Wang, Qian, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, Guangdong, China
- Ye, Zengchun, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, Guangdong, China
- Peng, Hui, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, Guangdong, China
Background
Malnutrition is one of the common complications in patients undergoing maintenance hemodialysis (MHD), which affects their life quality and expectancy. But there is lack of simple and effective nutritional screening tools for MHD patients.
Methods
A retrospective cohort of 831 patients on MHD were enrolled from three hospitals. We applied three objective nutritional scores including prognostic nutritional index (PNI), controlling nutritional states scores (CONUT), geriatric nutritional risk index (GNRI) to longitudinally assess the nutritional status of MHD patients and its relationship with prognosis, and to compare the predictive value of the three scores by using the concordance index (C-index), the integrated discrimination improvement (IDI), and net reclassification improvement (NRI) ; to explore the relationship of changes in nutritional status of MHD patients with their prognosis. The primary and secondary endpoint events were all-cause and cardiovascular mortality, respectively.
Results
During a median follow-up period of 31.13 months, 195 patients (23.5%) died,and 116 (14%) of them died from cardiovascular events. There was no significant difference in the risk of all-cause and cardiovascular mortality between the normal nutrition and malnutrition groups before hemodialysis in our cohort. The risk of all-cause mortality or cardiovascular mortality was greater in the malnutrition group at 6th, 12th and 18th months of dialysis. None of the PNI, GNRI, and CONUT score during pre-hemodialysis status was independent factor for both all-cause mortality and cardiovascular mortality of the cohort. The mortality predictability of the GNRI was similar to the PNI, and both GNRI and PNI score are better than the CONUT score. Patients with decreased PNI or GNRI scores had a significantly increased risk of all-cause and cardiovascular mortality compared with patients with higher PNI or GNRI scores. Meanwhile, patients with increased CONUT scores had a greater risk of all-cause mortality.
Conclusion
Each of the three nutritional screening tools was significantly associated with an increased risk for all-cause and cardiovascular mortality at 6th, 12th, and 18th month of hemodialysis. The predictive value of both GNRI and PNI score are better than the CONUT score