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Prognostic nutritional index is a predictor of mortality in elderly patients with chronic kidney disease

  • Nephrology - Original Paper
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Abstract

Purpose

Prognostic nutritional index (PNI), a composite indicator of inflammation and nutritional status, has recently been recognized as an independent prognostic marker for chronic kidney disease (CKD). We aimed to investigate PNI and its relationship with mortality in elderly patients with CKD.

Methods

Three hundred and fifty-nine patients over the age of 80 years with stage 3–4 CKD were enrolled in this retrospective study. PNI was used to assess the nutritional status of the patients. Patients were divided into two different groups as deceased and survived and as low PNI (< 39) and high PNI (≥ 39) according to median value of PNI.

Results

The mean age of the patients was 85.7 ± 3.7 years. One hundred and ninety-five (54.3%) patients died during follow-up. Multivariate analysis revealed that male gender, PNI, proteinuria, and diabetes mellitus (DM) were independent predictors of mortality in elderly patients with CKD. When patients with low PNI were compared to those with high PNI, initiation of dialysis and mortality rate were significantly higher whereas albumin, hemoglobin and lymphocyte count were lower. Pearson correlation analysis showed that PNI was significantly correlated with albumin (r = 1.000, p < 0.001), hemoglobin (r = 0.340, p < 0.001) and eGFR (r = 0.123, p = 0.020). Hemoglobin was an independent predictor of PNI in multivariate analysis.

Conclusion

In this study, we observed that PNI was significantly associated with mortality over the age of 80 years in patients with CKD and can be used to monitor nutritional status in this patient population.

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Data availability

All relevant data were presented in the manuscript.

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This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Nephrology, Department of Internal Medicine, School of Medicine, Marmara University, Pendik Teaching and Training Hospital, Fevzi Cakmak Mah. MuhsinYazicioglu Cad. No: 10 Ust Kaynarca-Pendik, Istanbul, Turkey

    Dilek Barutcu Atas, Murat Tugcu, Ebru Asicioglu, Arzu Velioglu, Hakki Arikan, Mehmet Koc & Serhan Tuglular

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  1. Dilek Barutcu Atas
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All authors have contributed significantly, and all authors are in agreement with the content of the manuscript. Each author has participated sufficiently in the work to take public responsibility for the content which include: conception or design, or analysis and interpretation of data, or both; drafting the article or revising it; providing intellectual content of critical importance to the work described and, final approval of the version to be published.

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Correspondence to Dilek Barutcu Atas.

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The study design was approved by the institutional review board of Marmara University Hospital (Protocol no: 09.2021.636) and complied with the Declaration of Helsinki.

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Barutcu Atas, D., Tugcu, M., Asicioglu, E. et al. Prognostic nutritional index is a predictor of mortality in elderly patients with chronic kidney disease. Int Urol Nephrol 54, 1155–1162 (2022). https://doi.org/10.1007/s11255-021-03002-6

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