Controlling Nutritional Status Score is Associated with All-Cause Mortality in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Abstract

PurposeThe controlling nutritional status (CONUT) score was developed to detect undernutrition in patients. Here, we investigated whether the CONUT score estimated at diagnosis could help predict poor outcomes [all-cause mortality, relapse, and end-stage renal disease (ESRD)] of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).Materials and MethodsWe retrospectively reviewed and collated data, including baseline characteristics, clinical manifestations (to calculate AAV-specific indices), and laboratory results, from 196 newly diagnosed AAV patients. Serum albumin, peripheral lymphocyte, and total cholesterol levels (at diagnosis) were used to calculate CONUT scores.ResultsIn total, 111 patients had high CONUT scores (≥3), which showed higher frequency of myeloperoxidase-ANCA and ANCA positivity, and demonstrated higher AAV-specific indices. The optimal cut-offs of CONUT score (at diagnosis) for predicting all-cause mortality and ESRD were ≥3.5 and ≥2.5, respectively. Patients with CONUT scores higher than the cut-off at diagnosis exhibited lower cumulative and ESRD-free survival rates compared to those with lower scores than the cut-off. In multivariable analyses, diabetes mellitus [hazard ratio (HR): 4.394], five-factor score (HR: 3.051), and CONUT score ≥3.5 (HR: 4.307) at diagnosis were independent predictors of all-cause mortality, while only serum creatinine (HR: 1.714) was an independent predictor of ESRD occurrence.ConclusionCONUT score at diagnosis is associated with all-cause mortality in AAV patients.

Predictive factors of mortality in granulomatosis with polyangiitis: A single-center study

“…2,6,9,11,12,14 However, compared to the patients included in other studies, our patients were younger, and only 10 patients were over 65 years old, indicating that age was not a risk factor. Furthermore, consistent with the findings of previous studies, 2,6,8,9,11,12,15 our results showed that high serum creatinine level was a risk factor for mortality. The cut-off value for creatinine was found to be >2.1 mg/dL.…”

“…9,11 Also, high BVAS was found to be an independent risk factor for mortality, consistent with our findings. 12 On the other hand, although an increased FFS value was reported to be a risk factor for mortality in previous studies, 6,8,15 the increase in FFS was not significant in our study (p=0.15).…”

“…Currently, the mortality rate in GPA remains high, despite available effective immunosuppressive treatments. 3,8,9 We believe that this study contributed to improve the survival rates of GPA patients by identifying risk factors of mortality in this patient population.…”

New body mass index for predicting prognosis in patients with antineutrophil cytoplasmic antibody‐associated vasculitis

“…30 Similarly, we demonstrated that a poor nutritional status was associated with a higher BVAS, and that it was a risk factor for ESRD occurrence. 31 One explanation for these findings is that underweight patients are at an increased risk of low muscle mass, 32,33 muscle mass is associated with chronic kidney disease. 34,35 The new BMI was proposed since the conventional BMI, which is defined as weight divided by height squared, has limitations in reflecting the three-dimensional human body.…”

Serological Biomarkers and Indices for the Current Activity and Prognosis of ANCA-Associated Vasculitis: Experience in a Single Centre in Korea

“…CONUT score at diagnosis was found to be associated with all-cause mortality during follow-up in AAV patients. 70 Systemic immune-inflammation index (SII) is a formula using three blood lineages as follows: SII=platelet count×neutrophil count/lymphocyte count. 71 In theory, the inflammatory burden of AAV may have the capability to increase the number of neutrophils and platelets, and decrease that of lymphocytes.…”