Association between Prognostic Nutritional Index and Contrast-Associated Acute Kidney Injury in Patients Complicated with Chronic Kidney Disease and Coronary Artery Disease

Dong, Xiao; Wang, Bo; Chen, Shiqun; Liu, Jin; Lei, Yu; Wang, Shouhong; Li, Bin; Wang, Sheng; Ying, Ming; Li, Huanqiang; Mai, Zihao; Yang, Yongquan; Chen, Jiyan; Liu, Yong; Qin, Tiehe; Tan, Ning

doi:10.1155/2021/2274430

Cited by 12 publications

(20 citation statements)

References 32 publications

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“…PNI is a lymphocyte and albumin-based index that was developed to robustly reflects the immunonutrition status of individuals. Emerging evidence have proved that PNI could predict the prognosis of several types of cancer [ 6 , 7 , 21 , 22 ], cardiovascular diseases [ 8 , 23 ] and acute kidney injury [ 24 ]. Furthermore, PNI was also related with the increased risk of mortality in children [ 25 ] and older patients with CKD [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic nutritional index as a risk factor for diabetic kidney disease and mortality in patients with type 2 diabetes mellitus

et al. 2022

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Aims Microinflammation and malnutrition are common in individuals with type 2 diabetes mellitus (T2DM). We aimed to validate whether prognostic nutritional index (PNI) may increase the risk of diabetic kidney disease (DKD) and all-cause mortality in T2DM patients. Methods This retrospective cohort study was based on the National Health and Nutrition Examination Survey (NHANES) and National Death Index (NDI) 2013–2018 database. A total of 14,349 eligible subjects were included, and 2720 of them were with T2DM. PNI was assessed by the 5 × lymphocyte count (10 9 /L) + serum albumin (g/L). The Logistic and Cox regression analyses were conducted to investigate the risk factors of DKD and mortality in T2DM patients. Results For 14,349 participants represented 224.7 million noninstitutionalized residents of the United State, the average PNI was 53.72 ± 0.12, and the prevalence of T2DM was 14.89%. T2DM patients had a lower level of PNI and dietary protein intake, a higher risk of mortality, kidney injury, anemia, arterial hypertension and hyperuricemia, compared with non-T2DM subjects. DKD occurred in 35.06% of diabetic participants and a higher PNI was independently related with a lower risk of DKD (OR 0.64, 95% CI 0.459–0.892, p = 0.01) in T2DM after multivariate adjustment. During a median follow-up of 46 person-months (29–66 months), a total of 233 T2DM individuals died from all causes (mortality rate = 8.17%). Subjects with T2DM who had a higher PNI showed a lower risk of all-cause mortality (HR 0.60, 95% CI 0.37–0.97, p = 0.036). Conclusions PNI, as a marker of immunonutrition, correlated with the incidence of DKD, and was an independent predictor for all-cause mortality in participants with T2DM. Thus, PNI may conduce to the risk stratification and timely intervention of T2DM patients.

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Section: Discussionmentioning

confidence: 99%

Prognostic nutritional index as a risk factor for diabetic kidney disease and mortality in patients with type 2 diabetes mellitus

et al. 2022

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“…29 As one of the most common components of the systemic inflammatory response, lymphocytes are well-known inflammatory markers involved in AKI. Increasing studies have taken the lymphocyte-based serum inflammatory biomarkers into consideration for the development of AKI and prognosis of patients in different populations, such as neutrophil-tolymphocyte ratio, 8,30,31 platelet-to-lymphocyte ratio, 32,33 prognostic nutritional index 34,35 and so on. However, limited data have focused on the combination of inflammatory factors and glucose metabolic factor.…”

Section: Dovepressmentioning

confidence: 99%

Preoperative Glucose-to-Lymphocyte Ratio is an Independent Predictor for Acute Kidney Injury After Cardiac Surgery in Patients in Intensive Care Unit

Li¹,

Zou²

2021

IJGM

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Background:We aimed to investigate the association between preoperative glucose-tolymphocyte ratio (GLR) and cardiac surgery associated with acute kidney injury (CSA-AKI) in patients in the intensive care unit (ICU). Methods: The Medical Information Mart for Intensive Care IV (MIMIC-IV version 1.0) database was used to identify adults' patients who performed cardiac surgery during ICU stay. The primary outcome was the development of AKI based on the KDIGO criteria. Multivariable logistic regression was applied to investigate the association between GLR and clinical outcomes, and propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were also used to validate our findings. Results: The optimal cut-off value for GLR was 1.28. Among the 7181 patients who conducted cardiac surgery, 2072 high-GLR group (≥1.28) patients and 2072 low-GLR group (<1.28) patients, had similar propensity scores were included in this study. After matching, the high-GLR group had a significantly higher incidence of AKI (odds ratio, OR, 3.28, 95% confidence index, 95% CI, 2.81-3.84, P <0.001) even after adjustment for confounding factors. Moreover, the performance of GLR was superior to that of SOFA scores and GLR plus clinical model could add more net benefit for CSA-AKI than clinical model alone. Conclusion:Preoperative GLR could serve as a good predictor for CSA-AKI in patients in ICU.

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“…Several risk factors including older age, hemodynamic instability, pre-existing renal failure, diabetes mellitus (DM), heart failure, and the volume of contrast media have been reported to be linked to the development of CIN ( 3 ). On the other hand, malnutrition, which is commonly observed in critically ill patients and known to tightly correlate with acute kidney injury, has not been well studied ( 7 – 9 ). Among different assessments of nutritional status, the prognostic nutritional index (PNI), calculated based on the serum albumin concentration and peripheral blood lymphocyte count, is a reliable indicator of nutritional and immune status ( 9 – 11 ).…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, malnutrition, which is commonly observed in critically ill patients and known to tightly correlate with acute kidney injury, has not been well studied ( 7 – 9 ). Among different assessments of nutritional status, the prognostic nutritional index (PNI), calculated based on the serum albumin concentration and peripheral blood lymphocyte count, is a reliable indicator of nutritional and immune status ( 9 – 11 ). Although PNI has been frequently applied in patients with malignancy or those during postoperative recovery ( 10 , 12 , 13 ), whether it is also an optimal indicator of the risk of CIN in patients receiving coronary angiography remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

Association of prognostic nutritional index with risk of contrast induced nephropathy: A meta-analysis

Chang

Sun

et al. 2023

Front. Nutr.

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BackgroundAlthough prognostic nutritional index (PNI) has been frequently applied in patients with malignancy or those during postoperative recovery, whether it is also an optimal indicator of the risk of contrast-induced nephropathy (CIN) in patients receiving coronary angiography remains uncertain. This meta-analysis aimed at investigating the clinical association of PNI with the risk of CIN in patients receiving coronary angiography or percutaneous coronary intervention.MethodsEmbase, Medline, Cochrane Library, and Google scholar were searched for studies until January 2023. The relationship between CIN risk and PNI (i.e., low vs. high) (primary outcome) as well as other variables (secondary outcomes) were analyzed using a random-effects model.ResultsOverall, 10 observational studies with 17,590 patients (pooled incidence of CIN: 18%) were eligible for analysis. There was a higher risk of CIN in patients with a low PNI compared to those with a high PNI [odd ratio (OR) = 3.362, 95% confidence interval (CI): 2.054 to 5.505, p < 0.0001, I2 = 89.6%, seven studies, 12,972 patients, certainty of evidence: very low]. Consistently, a lower PNI was noted in patients with CIN compared to those without (Mean difference = −5.1, 95% CI: −6.87 to −3.33, p < 0.00001, I2 = 96%, eight studies, 15,516 patients, certainty of evidence: very low). Other risks of CIN included diabetes and hypertension, while male gender and the use of statins were associated with a lower risk of CIN. Patients with CIN were older, had a higher creatinine level, and received a higher contrast volume compared to those without. On the other hand, pre-procedural albumin, estimated glomerular filtration rate, ejection fraction, hemoglobin, lymphocyte ratio were found to be lower in patients with CIN than in those without.ConclusionThis meta-analysis highlighted an inverse association of PNI with the risk of CIN, which required further studies for verification.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42023389185].

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Association between Prognostic Nutritional Index and Contrast-Associated Acute Kidney Injury in Patients Complicated with Chronic Kidney Disease and Coronary Artery Disease

Cited by 12 publications

References 32 publications

Prognostic nutritional index as a risk factor for diabetic kidney disease and mortality in patients with type 2 diabetes mellitus

Prognostic nutritional index as a risk factor for diabetic kidney disease and mortality in patients with type 2 diabetes mellitus

Preoperative Glucose-to-Lymphocyte Ratio is an Independent Predictor for Acute Kidney Injury After Cardiac Surgery in Patients in Intensive Care Unit

Association of prognostic nutritional index with risk of contrast induced nephropathy: A meta-analysis

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