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

• Published in: Yonsei medical journal Vol. 60; no. 12; pp. 1164 - 1173
• Main Authors: Ahn, Sung Soo, Jung, Seung Min, Song, Jason Jungsik, Park, Yong-Beom, Lee, Sang-Won
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.12.2019; 연세대학교의과대학
• Subjects: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - blood; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - diagnosis; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - mortality; Antibodies, Antineutrophil Cytoplasmic - blood; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Kidney Failure, Chronic - etiology; Male; Middle Aged; Multivariate Analysis; Nutritional Status; Original; Proportional Hazards Models; Retrospective Studies; ROC Curve; Survival Rate; 의학일반; predictor; ANCA-associated vasculitis; all-cause mortality; CONUT score
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2019.60.12.1164

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). 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. 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. CONUT score at diagnosis is associated with all-cause mortality in AAV patients.