Onodera's Prognostic Nutritional Index as a Risk Factor for Mortality in Peritoneal Dialysis Patients

Abstract

The aim of this study was to evaluate the clinical relevance and usefulness of the Onodera's prognostic nutritional index (OPNI) as a prognostic and nutritional indicator in peritoneal dialysis (PD) patients. Patients were divided into 3 groups based on the initial OPNI score: group A (n = 186, < 40), group B (n = 150, 40-45), and group C (n = 186, > 45). Group A was associated with a higher grade according to the Davies risk index than the other groups. Serum creatinine and albumin levels, total lymphocyte count, and fat mass increased with an increase in OPNI. According to the edema index, the correlation coefficient for OPNI was -0.284 and for serum albumin was -0.322. Similarly, according to the C-reactive protein (CRP), the correlation coefficient for OPNI was -0.117 and for serum albumin was -0.169. Multivariate analysis adjusted for age, Davies risk index, CRP, and edema index revealed that the hazard ratios for low OPNI, serum albumin, and CRP were 1.672 (P = 0.003), 1.308 (P = 0.130), and 1.349 (P = 0.083), respectively. Our results demonstrate that the OPNI is a simple method that can be used for predicting the nutritional status and clinical outcome in PD patients.

Risk Factors for Anastomotic Leakage of Esophagojejunostomy after Laparoscopy-Assisted Total Gastrectomy for Gastric Cancer

“…The Onodera PNI was originally proposed as a preoperative risk factor for gastrointestinal operation and a determinant of surgical indication in colorectal cancer but is now used widely as an indicator of nutritional assessment not only in the field of gastrointestinal surgery but also for the general hospital population. Perioperative nutrition status plays an important role in the incidence of postoperative complications [25,27,28] and on the overall survival after the resection of malignant tumors [15,[25][26][27][29][30][31]. A study also showed that PNI is an independent prognostic factor for overall and disease-specific survival in patients with gastric cancer [32].…”

“…Hospitals that recognize the importance of nutritional therapy now have a nutrition support team, and the PNI is commonly used for their nutritional assessments [28][29][30]38]. This retrospective study has several limitations.…”

Pre-operative nutritional serum parameters as predictors of failure after internal fixation in undisplaced intracapsular proximal femur fractures

“…Similarly, an association between post-operative complications and depleted nutritional parameters has been reported following elective arthroplasty surgery [12]. Low lymphocyte or albumin counts are also predictive of mortality in ill health including renal dialysis [13,14] and cancer [15,16] as well as in the older population without apparent disease [17]. To our knowledge a similar relationship to fracture healing and fixation has not been previously investigated.…”

Phase Angle and Onodera’s Prognostic Nutritional Index in critically ill patients

“…However, it is important to underscore that in critically ill patients this parameter can be changed by clinical status or the use of medication. Thus, OPNI seems to be better employed in patients receiving peritoneal dialysis, and those with terminal liver disease and active tuberculosis (10).…”

“…Low PA values are associated with morbidity and mortality in critically ill patients (9). OPNI, in turn, originally developed to predict prognosis in surgical patients, is a simple tool using measures of serum albumin and total lymphocyte Count (TLC) that can be rapidly applied in a large number of patients (10).…”