Impact of the prognostic nutritional index on renal replacement therapy–free survival and mortality in patients on continuous renal replacement therapy
Background The survival of critically ill patients with acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT) is highly dependent on their nutritional status.Objectives The prognostic nutritional index (PNI) is an indicator used to assess nutritional status and is calculat...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2365394 |
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| author | Yu-Fu Lee Pei-Ru Lin Shin-Hwar Wu Hsin-Hui Hsu Shu-Yun Yang Chew-Teng Kor |
| author_facet | Yu-Fu Lee Pei-Ru Lin Shin-Hwar Wu Hsin-Hui Hsu Shu-Yun Yang Chew-Teng Kor |
| author_sort | Yu-Fu Lee |
| collection | DOAJ |
| description | Background The survival of critically ill patients with acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT) is highly dependent on their nutritional status.Objectives The prognostic nutritional index (PNI) is an indicator used to assess nutritional status and is calculated as: PNI = (serum albumin in g/dL) × 10 + (total lymphocyte count in/mm3) × 0.005. In this retrospective study, we investigated the correlation between this index and clinical outcomes in critically ill patients with AKI receiving CRRT.Methods We analyzed data from 2076 critically ill patients admitted to the intensive care unit at Changhua Christian Hospital, a tertiary hospital in central Taiwan, between January 1, 2010, and April 30, 2021. All these patients met the inclusion criteria of the study. The relationship between PNI and renal replacement therapy-free survival (RRTFS) and mortality was examined using logistic regression models, Cox proportional hazard models, and propensity score matching. High utilization rate of parenteral nutrition (PN) was observed in our study. Subgroup analysis was performed to explore the interaction effect between PNI and PN on mortality.Results Patients with higher PNI levels exhibited a greater likelihood of achieving RRTFS, with an adjusted odds ratio of 2.43 (95% confidence interval [CI]: 1.98-2.97, p-value < 0.001). Additionally, these patients demonstrated higher survival rates, with an adjusted hazard ratio of 0.84 (95% CI: 0.72-0.98) for 28-day mortality and 0.80 (95% CI: 0.69-0.92) for 90-day mortality (all p-values < 0.05), compared to those in the low PNI group. While a high utilization rate of parenteral nutrition (PN) was observed, with 78.86% of CRRT patients receiving PN, subgroup analysis showed that high PNI had an independent protective effect on mortality outcomes in AKI patients receiving CRRT, regardless of their PN status.Conclusions PNI can serve as an easy, simple, and efficient measure of lymphocytes and albumin levels to predict RRTFS and mortality in AKI patients with require CRRT. |
| format | Article |
| id | doaj-art-660db286ef1d46cbb8bf09cb223bbbe4 |
| institution | DOAJ |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-660db286ef1d46cbb8bf09cb223bbbe42025-08-20T03:05:26ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2365394Impact of the prognostic nutritional index on renal replacement therapy–free survival and mortality in patients on continuous renal replacement therapyYu-Fu Lee0Pei-Ru Lin1Shin-Hwar Wu2Hsin-Hui Hsu3Shu-Yun Yang4Chew-Teng Kor5Division of Critical Care Internal Medicine, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua, TaiwanBig Data Center, Changhua Christian Hospital, Changhua, TaiwanDivision of Critical Care Internal Medicine, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua, TaiwanDivision of Critical Care Internal Medicine, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua, TaiwanDivision of Critical Care Internal Medicine, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua, TaiwanBig Data Center, Changhua Christian Hospital, Changhua, TaiwanBackground The survival of critically ill patients with acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT) is highly dependent on their nutritional status.Objectives The prognostic nutritional index (PNI) is an indicator used to assess nutritional status and is calculated as: PNI = (serum albumin in g/dL) × 10 + (total lymphocyte count in/mm3) × 0.005. In this retrospective study, we investigated the correlation between this index and clinical outcomes in critically ill patients with AKI receiving CRRT.Methods We analyzed data from 2076 critically ill patients admitted to the intensive care unit at Changhua Christian Hospital, a tertiary hospital in central Taiwan, between January 1, 2010, and April 30, 2021. All these patients met the inclusion criteria of the study. The relationship between PNI and renal replacement therapy-free survival (RRTFS) and mortality was examined using logistic regression models, Cox proportional hazard models, and propensity score matching. High utilization rate of parenteral nutrition (PN) was observed in our study. Subgroup analysis was performed to explore the interaction effect between PNI and PN on mortality.Results Patients with higher PNI levels exhibited a greater likelihood of achieving RRTFS, with an adjusted odds ratio of 2.43 (95% confidence interval [CI]: 1.98-2.97, p-value < 0.001). Additionally, these patients demonstrated higher survival rates, with an adjusted hazard ratio of 0.84 (95% CI: 0.72-0.98) for 28-day mortality and 0.80 (95% CI: 0.69-0.92) for 90-day mortality (all p-values < 0.05), compared to those in the low PNI group. While a high utilization rate of parenteral nutrition (PN) was observed, with 78.86% of CRRT patients receiving PN, subgroup analysis showed that high PNI had an independent protective effect on mortality outcomes in AKI patients receiving CRRT, regardless of their PN status.Conclusions PNI can serve as an easy, simple, and efficient measure of lymphocytes and albumin levels to predict RRTFS and mortality in AKI patients with require CRRT.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2365394Continuous renal replacement therapyprognostic nutritional indexrenal replacement therapy–free survivalmortalityICUcritically ill patient |
| spellingShingle | Yu-Fu Lee Pei-Ru Lin Shin-Hwar Wu Hsin-Hui Hsu Shu-Yun Yang Chew-Teng Kor Impact of the prognostic nutritional index on renal replacement therapy–free survival and mortality in patients on continuous renal replacement therapy Renal Failure Continuous renal replacement therapy prognostic nutritional index renal replacement therapy–free survival mortality ICU critically ill patient |
| title | Impact of the prognostic nutritional index on renal replacement therapy–free survival and mortality in patients on continuous renal replacement therapy |
| title_full | Impact of the prognostic nutritional index on renal replacement therapy–free survival and mortality in patients on continuous renal replacement therapy |
| title_fullStr | Impact of the prognostic nutritional index on renal replacement therapy–free survival and mortality in patients on continuous renal replacement therapy |
| title_full_unstemmed | Impact of the prognostic nutritional index on renal replacement therapy–free survival and mortality in patients on continuous renal replacement therapy |
| title_short | Impact of the prognostic nutritional index on renal replacement therapy–free survival and mortality in patients on continuous renal replacement therapy |
| title_sort | impact of the prognostic nutritional index on renal replacement therapy free survival and mortality in patients on continuous renal replacement therapy |
| topic | Continuous renal replacement therapy prognostic nutritional index renal replacement therapy–free survival mortality ICU critically ill patient |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2365394 |
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