Determination of nutrition index and correlation with activity of lupus nephritis

Abstract

Background/Aim. Lupus nephritis (LN), as an immuno-inflammatory kidney lesion, and the most serious manifestation of systemic lupus erythematosus (SLE), is accompanied by a disorder of the nutritional status of patients. Our goal was to determine the importance of determining and the association of parameters of nutritional status - nutritional risk index (NRI), prognostic nutritional index (PNI) and control nutritional status (CONUT) with standard parameters of LN activity. Methods. The clinical study included a group of 92 subjects. 67 patients had LN (34 patients had LN active disease , the LNa group, and 33 patients were in LN remission, the LNr group) and 25 healthy subjects (control group). In addition to standard laboratory parameters, LN activity parameters, derived parameters were also determined: PNI=10 x albumin value (g/dL) + 0.005 x number of peripheral lymphocytes (/mm3); NRI = 1.519 ? serum albumin, g/dL + 41.7 ? weight (kg)/ideal body weight ( kg); CONUT score = serum albumin + total lymphocyte score + total cholesterol. Results. A statistically significant difference between all three groups was observed for the PNI (p=0.001) and for the CONUT score (p=0.000), while the NRI did not have a significant difference. Statistical significance was found for the correlation of PNI in the LNa group, with the levels of albumin, complement C3 and C4, and a significant negative correlation with the value of anti-ds-DNA Ab. NRI correlated with statistical significance only with proteinuria in the LNa group. CONUT showed significant correlations with the most of the parameters for disease activity: negative correlation with albumin and complement C3 (p = 0.000), and positive correlation with anti -double strand (ds) - DNA Antibody (p=0.002),with Systemic Lupus Erythematosus Disease Activity Index/renal (SLEDAI/r) and with proteinuria/24 hrs (p=0.000). Conclusion. In our group of patients, a statistically significant difference was observed between the groups for the nutrition score CONUT. and the PNI. Their correlation with standard parameters of active disease was significant for most parameters in the group of patients with LNa.