Prognostic Value of the Controlling Nutritional Status (CONUT) Score in Patients at Dialysis Initiation

Nutrients. 2022 May 31;14(11):2317. doi: 10.3390/nu14112317.

Abstract

Protein-energy wasting (PEW) is common in patients with chronic kidney disease (CKD), and affects their prognosis. The Controlling Nutritional Status (CONUT) score is a nutritional screening tool calculated using only blood test data. This study aimed to investigate the prognostic value of CONUT score in patients just initiating dialysis. A total of 311 CKD patients who stably initiated dialysis were enrolled. Only 27 (8.7%) patients were classified as having normal nutritional status. The CONUT score was also independently correlated with elevated C-reactive protein levels (β = 0.485, p < 0.0001). During the median follow-up of 37 months, 100 patients (32.2%) died. The CONUT score was an independent predictor of all-cause mortality (adjusted hazard ratio 1.13, 95% confidence interval 1.04−1.22, p < 0.0024). As model discrimination, the addition of the CONUT score to a prediction model based on established risk factors significantly improved net reclassification improvement (0.285, p = 0.028) and integrated discrimination improvement (0.025, p = 0.023). The CONUT score might be a simplified surrogate marker of the PEW with clinical utility and could predict all-cause mortality, in addition to improving the predictability in CKD patients just initiating dialysis. The CONUT score also could predict infectious-disease mortality.

Keywords: CONUT; chronic kidney disease; dialysis; mortality; nutritional assessment; protein-energy wasting.

MeSH terms

  • Humans
  • Nutrition Assessment
  • Nutritional Status*
  • Prognosis
  • Renal Dialysis
  • Renal Insufficiency, Chronic* / therapy
  • Retrospective Studies

Grants and funding

This research received no external funding.