AUTHOR=Huo Qingyu , He Ting , Xiong Jiachuan , Zhao Jinghong 

TITLE=Controlling nutritional status score is associated with renal progression, cardiovascular events, and all-cause mortality in biopsy-proved diabetic kidney disease

JOURNAL=Frontiers in Physiology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2023.1231448

DOI=10.3389/fphys.2023.1231448

ISSN=1664-042X

ABSTRACT=<p><bold>Background:</bold> The Controlled Nutritional Status (CONUT) score, calculated from albumin, total cholesterol, and lymphocyte count, is a useful indicator for immune-nutritional assessment and is associated with the prognosis of various diseases. However, its relationship with renal outcomes, cardiovascular disease (CVD), and all-cause mortality in patients with diabetic kidney disease is unclear.</p><p><bold>Methods:</bold> This retrospective single-center study enrolled 336 patients with biopsy-confirmed diabetic kidney disease from August 2009 to December 2018. The outcomes were progression to end-stage renal disease (ESRD), CVD events, and death. Univariate and multivariate Cox regression analyses were performed to estimate the association between confounding factors and outcomes. The Kaplan-Meier curve was used to compare the outcomes of the patients according to the median CONUT score. The area under the curve (AUC) evaluated with time-dependent receiver operating characteristics was used to test discriminative power of COUNT score.</p><p><bold>Results:</bold> During a median follow-up period of 5.1 years. The Kaplan-Meier analysis showed that patients in the high CONUT group (CONUT score &gt; 3) had a significantly higher incidence of ESRD, CVD events, and all-cause mortality than those in the low CONUT group (CONUT score ≤ 3). The multivariate COX regression analysis indicated that, The CONUT score was an independent predictor of ESRD (hazards ration [HR] = 1.129, 95% confidence interval [CI] 1.037-1.228, <italic>p</italic> = 0.005), CVD events (HR = 1.159, 95% CI 1.057-1.271, <italic>p</italic> = 0.002), and all-cause mortality (HR = 1.299, 95% CI 1.143-1.478, <italic>p</italic> &lt; 0.001).</p><p><bold>Conclusion:</bold> The CONUT score is an independent risk factor for ESRD, CVD events, and overall death in patients with diabetic kidney disease.</p>