Abstract: SA-PO1175
Kidney Dysfunction Amplifies the Prognostic Utility of the CONUT Score for Unplanned Heart Failure Readmission
Session Information
- CKD: SGLT2 Inhibitors and GLP-1 RAs for Kidney Health
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Abe, Yoshifumi, Tokyo Iryo Gakuin Daigaku, Tama, Tokyo, Japan
- Akiho, Mitsutoshi, Tokyo Iryo Gakuin Daigaku, Tama, Tokyo, Japan
- Tanaka, Hideki, Mitsui Kinen Byoin, Chiyoda, Tokyo, Japan
- Watanabe, Takaaki, Tokyo Iryo Gakuin Daigaku, Tama, Tokyo, Japan
- Matsumoto, Naoto, Tokyo Iryo Gakuin Daigaku, Tama, Tokyo, Japan
- Horiuchi, Yu, Mitsui Kinen Byoin, Chiyoda, Tokyo, Japan
Background
Malnutrition worsens outcomes in heart failure (HF); however, it remains unclear whether the Controlling Nutritional Status (CONUT) score maintains prognostic value across different levels of renal function. Previous studies evaluated nutritional indices in unselected HF cohorts, but no studies have specifically examined whether moderate-to-severe renal dysfunction modifies CONUT's impact on HF readmission.
Methods
We retrospectively analyzed 297 HF admissions (median age 78 years [interquartile range (IQR), 69–84]; 37% women) between April 2017 and March 2021. Chronic kidney disease (CKD) was defined as eGFR < 45 mL/min/1.73 m2 (n = 157). Admission CONUT, Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI) were calculated. The endpoint was unplanned HF readmission. Multivariable Cox models, adjusted for age, sex, left ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide (NT-proBNP), diabetes, and prior HF admission, were fitted separately within CKD and non-CKD strata. Kaplan–Meier curves used the optimal CONUT cut-off (Youden index = 4).
Results
Median follow-up was 266 days (IQR, 108–542 days); 116 patients (39%) were readmitted. In the CKD group (47% readmitted), higher CONUT independently predicted readmission (HR 1.48, 95% CI 1.12–1.97; p = 0.005). One-year readmission was 35% for CONUT ≥ 4 vs 18% for CONUT < 4 (log-rank p = 0.003). In the non-CKD group (30% readmitted), CONUT was not associated with readmission (HR 0.99; p = 0.94). GNRI and PNI were not independent predictors in either stratum. A significant interaction between CONUT and CKD status was observed (p for interaction = 0.03).
Conclusion
The CONUT score predicts unplanned HF readmission exclusively in CKD stage ≥ G3b, whereas GNRI and PNI provide no prognostic value in either stratum. Limitations include a single-center retrospective design and a median follow-up of 9 months. Admission-time CONUT screening may help clinicians target nutritional and HF-specific interventions to patients with high cardiorenal risk.