Prognostic significance of malnutrition scores in elderly patients for the prediction of contrast-induced acute kidney injury.

Abstract

BACKGROUND:

Malnutrition reflects the general condition of a patient including physical condition, protein turnover, and immune competence. Contrast-induced acute kidney injury (CI-AKI) is a disorder that adversely affects the prognosis of older adults. In our study, we aimed to show the relationship between CI-AKI and malnutrition status in elderly patients over 65 years of age with chronic coronary artery disease (CAD).

METHODS:

Study enrolled 360 consecutive patients with coronary angiography performed because of chronic coronary artery disease. Patients pre-procedural and post-procedural blood samples were taken and prognostic nutritional index (PNI), controlling nutritional status (CONUT) score, and geriatric nutritional risk index (GNRI) malnutrition scores were calculated.

RESULTS:

The median age of the patients included in the study was 69 (67-72, IQR) and CI-AKI was seen in 91 (25.2%) patients. Univariate regression analysis showed that age, diabetes mellitus, baseline creatinine, body weight-adapted contrast agent, haemoglobin, left ventricular ejection fraction, CONUT score, PNI score, and GNRI score were independent predictors of CI-AKI. In model 1, increase in CONUT score (2 to 5) (OR: 3.21 (2.11-4.88), in model 2, increase in PNI score (37.4 to 45) (OR: 0.34, (0.24-0.49)), and in model 3, increase in GNRI score (89.5 to 103.8) (OR: 0.55, (0.38-0.81)) were independently associated with the presence of CI-AKI. PNI showed better results than other models in discriminating the predictable capability for CI-AKI.

CONCLUSION:

Malnutrition assessment of elderly patients before performing diagnostic or interventional coronary procedures could help clinicians to identify patients with elevated risk for CI-AKI.

• Authors: Süleyman C Efe, Ali Karagöz, Cem Doğan, Zübeyde Bayram, Ender O Cakmak, Sedat Kalkan, Kürsat Aslan, Saadet Güven, Halil Ibrahim Tanboga, Burak Ayca, Turgut Karabağ, Cihangir Kaymaz, Nihal Ozdemir
• Journal: International journal of clinical practice (Int J Clin Pract) Vol. 75 Issue 7 Pg. e14274 (Jul 2021) ISSN: 1742-1241 [Electronic] India
• PMID: 33908146 (Publication Type: Journal Article)
• Copyright: © 2021 John Wiley & Sons Ltd.

Topics

• Acute Kidney Injury (chemically induced, diagnosis, epidemiology)
• Aged
• Humans
• Malnutrition (diagnosis)
• Nutrition Assessment
• Nutritional Status
• Prognosis
• Retrospective Studies
• Risk Factors
• Stroke Volume
• Ventricular Function, Left