Association Between Comprehensive Nutritional Scoring System (CNSS) and Outcomes of Continuous Ambulatory Peritoneal Dialysis Patients.

Background/Aims: The presence of protein-energy wasting (PEW) among dialysis patients is a crucial risk factor for outcomes. The complicated pathogenesis of PEW makes it difficult to assess and treat. This single-center retrospective study focuses on the association between nutritional markers and the outcomes of continuous ambulatory peritoneal dialysis(CAPD) patients, aiming to establish a practical comprehensive nutritional scoring system for CAPD patients. Methods: 924 patients who initiated peritoneal dialysis in our center from January 1st, 2005 to December 31st, 2015 were enrolled. Comprehensive nutritional scoring system(CNSS) was based on items including SGA, BMI, ALB, TC, MAC and TSF. We divide patients into 3 groups according to their CNSS score. Outcomes including mortality, hospitalization days and hospitalization frequency were compared between 3 grades. Results: The CNSS grade correlated significantly with hospitalization days (P<0.05). Both categorized CNSS grade (HR: 0.56; 95% CI: 0.41-0.78; P = 0.001) and continuous CNSS score (HR: 0.87; 95% CI: 0.80-0.94; P = 0.001) independently protect PD patients from all-cause mortality. Conclusion: CNSS provides an integrated scoring system with significant associations with hospitalization and mortality in PD patients. The CNSS grade differentiates patients with malnutritional risk and independently predicts high risk of morbidity and mortality. (C) 2017 The Author(s) Published by S.Karger AG, Basel