Prognostic significance of controlling nutritional status (CONUT) score in hemodialysis patients

Abstract

Introduction: Malnutrition is a common and important problem in HD Hemodialysis (HD) patients. Malnutrition occurs due to various factors increases the risk of morbidity and mortality in HD patients. The Controlling Nutritional Status (CONUT) score has been designed to assess the nutritional status in patients. In addition, the relationship between the CONUT score and mortality has been investigated. We aimed to investigate the effectiveness of the CONUT score in predicting mortality in HD patients. Material and Method: The data of 110 patients who started HD between 2017-2021 were analyzed retrospectively. From the laboratory parameters were evaluated before starting the first hemodialysis treatment. The CONUT score was calculated based on lymphocyte count, total cholesterol levels, and serum albumin levels. The patients were divided into two groups as CONUT score ≤4 and CONUT score ≥5. The groups were compared regarding these parameters. Results: The data of 110 hemodialysis patients were analyzed. 58 (52.7%) of these patients were male. The mean age of the patients was 53.18±17.10 years. There were 49 (44.5%) patients with a CONUT score of ≤4 and 61 (55.5%) patients with a CONUT score of ≥5. 35 patients (13.9%) died. Among 35 all-cause deaths, 4 (11.4%) were occurred in the low CONUT group, and 31 (88.6%) were occurred in the high CONUT group (p<0.001). According to Kaplan-Meier analysis, the high CONUT group had significantly higher all-cause mortality (p<0.001) than the low CONUT group. According to the correlation analysis, there was a positive correlation between the CONUT score and mortality (p<0.001). In the multivariate Cox regression analysis, all cause of mortality was independently correlated to age, gender (male) and CONUT score (p: 0.010, p: 0.038 and p < 0.001, respectively). According to the ROC curve analysis, the optimal cut-off value of CONUT score in Hemodialysis HD patients was found at 4.5. Conclusion:We concluded that the higher the CONUT score, the worse the nutritional status in hemodialysis patients, and may be associated with worse clinical outcomes. It is extremely important to evaluate the nutritional status at regular intervals, to detect malnutrition early and to follow up the results in HD patients. We think that CONUT score can be useful in predicting mortality risk for HD patients in clinical practice.