Yonsei Med J.  2019 Dec;60(12):1164-1173. 10.3349/ymj.2019.60.12.1164.

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

• Ahn SS
• Jung SM
• Song JJ
• Park YB
• Lee SW

• KMID: 2463795
• DOI: http://doi.org/10.3349/ymj.2019.60.12.1164

Abstract

PURPOSE
The 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 METHODS
We 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.
RESULTS
In 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.
CONCLUSION
CONUT score at diagnosis is associated with all-cause mortality in AAV patients.

Keyword

ANCA-associated vasculitis; CONUT score; all-cause mortality; predictor

MeSH Terms

Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Antibodies, Antineutrophil Cytoplasmic
Cholesterol
Creatinine
Cytoplasm*
Diabetes Mellitus
Diagnosis
Humans
Kidney Failure, Chronic
Lymphocytes
Malnutrition
Mortality*
Nutritional Status*
Recurrence
Retrospective Studies
Serum Albumin
Survival Rate
Vasculitis*
Antibodies, Antineutrophil Cytoplasmic
Cholesterol
Creatinine
Serum Albumin

Figure

• 

  Fig. 1 Receiver operator characteristics curve analysis of controlling nutritional status score at diagnosis for predicting occurrence of (A) all-cause mortality, (B) relapse, and (C) end-stage renal disease (ESRD). CI, confidence interval.

• 

  Fig. 2 Kaplan-Meier analysis of controlling nutritional status (CONUT) score at diagnosis for predicting occurrence of all-cause mortality and end-stage renal disease (ESRD) during follow-up. (A) All-cause mortality and (B) ESRD.

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