CONUT, PNI predict technique failure during peritoneal dialysis

In patients undergoing peritoneal dialysis (PD), the Controlling Nutritional Status (CONUT) score and Prognostic Nutritional Index (PNI) seem to be independent predictors of technique failure (TF), a recent study has found.

The study included 276 patients on PD (mean age 48.2±14.6 years, 57.6 percent men) whose nutritional status was determined using the CONUT, PNI, and Geriatric Nutritional Risk Index (GNRI). The primary outcome of TF was defined as the permanent switch from PD to haemodialysis.

Eighty-four participants (30.43 percent) experienced TF during the study duration. This group had a significantly greater percentage of men (p=0.005), had higher body mass index (p=0.007), and were more likely to have early peritonitis (p=0.013) than non-TF comparators.

In terms of nutritional indices, TF patients had significantly higher median CONUT scores (5 vs 4; p=0.011) and lower mean PNI (34.43±4.96 vs 38.94±5.57; p=0.014). No between-group difference was reported for GNRI (p=0.085).

Multivariate Cox regression confirmed that CONUT score >3 (hazard ratio [HR], 2.284, 95 percent confidence interval [CI], 1.248–4.179; p=0.007) and PNI ≤40.2 (HR, 2.070, 95 percent CI, 1.233–3.475; p=0.006) were significant and independent correlates of TF. Meanwhile, GNRI was found to be nonsignificant in univariate analysis (p=0.170).

“Our study indicates that objective nutritional indexes, in particular the CONUT score and PNI, might predict TF in PD patients. Our findings help clinicians identify high-risk TF patients and provide early nutritional interventions,” the researchers said.