The predictive value of prognostic nutritional index combined with CAR and Alb for the long-term prognosis of peritoneal dialysis patients
Objective To assess the predictive value of the prognostic nutritional index(PNI)in combination with the C-reactive protein/albumin ratio(CAR)and serum albumin(Alb)for the long-term prog-nosis of peritoneal dialysis(PD)patients.Methods In a retrospective analysis,102 end-stage renal disease pa-tients who underwent peritoneal dialysis(PD)treatment at the Nephrology Department of the First People's Hospital of Zigong City from January 2019 to January 2024 were included.Based on the 5-year follow-up pe-riod,PD patient survival outcomes were categorized into a deceased group(n=3)and a surviving group(n=69).Univariate and multivariate logistic regression analyses were employed to identify independent risk factors affecting the long-term prognosis of PD patients.Receiver Operating Characteristic(ROC)curves were gener-ated to assess the predictive value of combining the Prognostic Nutritional Index(PNI)with the C-reactive pro-tein/albumin ratio(CAR)and serum albumin(Alb)for PD patient survival outcomes.Results Compared to the survival group,the mortality group had a higher proportion of patients with diabetes,cardiovascular dis-eases,and complications of peritonitis(x2=0.947,4.846,5.840).The levels of glomerular filtration rate(eGFR),Prognostic Nutritional Index(PNI),and albumin(Alb)were lower(t=9.495,6.068,5.422).The levels of serum creatinine(SCR),uric acid(UA),and C-reactive protein to albumin ratio(CAR)were higher(t=5.369,4.581,5.048),with all these indicators showing statistically significant differences(P<0.05).Ac-cording to logistic regression analysis,the presence of diabetes,cardiovascular diseases,and an increased CAR were identified as independent risk factors for mortality in PD patients(P<0.05).Conversely,higher eGFR,PNI,and Alb levels were recognized as independent protective factors against mortality in PD patients(P<0.05).ROC curve analysis revealed that the combined prediction of PNI,CAR,and Alb had a significantly higher area under the curve(0.928)compared to individual predictions(P<0.05).Conclusion Diminished levels of PNI and Alb,coupled with an increased CAR,stand out as independent factors impacting mortality in PD patients.These three indicators collectively offer valuable insights into the long-term prognosis and survival outcomes of PD patients,with their combined predictive efficacy proving superior.
NETL
NSTL
万方数据
