PMID- 36079889 OWN - NLM STAT- MEDLINE DCOM- 20220912 LR - 20230308 IS - 2072-6643 (Electronic) IS - 2072-6643 (Linking) VI - 14 IP - 17 DP - 2022 Sep 2 TI - Prognostic Nutritional Index as a Predictor of Diabetic Nephropathy Progression. LID - 10.3390/nu14173634 [doi] LID - 3634 AB - Malnutrition and immunologic derangement were not uncommon in patients with chronic kidney disease (CKD). However, the long-term effects of prognostic nutritional index (PNI), an immunonutrition indictor, on renal outcomes in patients with diabetic nephropathy (DN) and type 2 diabetes mellitus (T2DM) are unknown. In this retrospective cohort study, 475 patients with T2DM and biopsy-confirmed DN from West China Hospital between January 2010 and September 2019 were evaluated. PNI was evaluated as serum albumin (g/L) + 5 x lymphocyte count (109/L). The study endpoint was defined as progression to end-stage renal disease (ESRD). The Cox regression analysis was performed to investigate the risk factors of renal failure in DN patients. A total of 321 eligible individuals were finally included in this study. The patients with higher PNI had a higher eGFR and lower proteinuria at baseline. Correlation analysis indicated PNI was positively related eGFR (r = 0.325, p < 0.001), and negatively correlated with proteinuria (r = -0.68, p < 0.001), glomerular lesion (r = -0.412, p < 0.001) and interstitial fibrosis and tubular atrophy (r = -0.282, p < 0.001). During a median follow-up of 30 months (16-50 months), the outcome event occurred in 164(51.09%) of all the patients. After multivariable adjustment, each SD (per-SD) increment of PNI at baseline was associated with a lower incidence of ESRD (hazard ratio, 0.705, 95% CI, 0.523-0.952, p = 0.023), while the hypoalbuminemia and anemia were not. For the prediction of ESRD, the area under curves (AUC) evaluated with time-dependent receiver operating characteristics were 0.79 at 1 year, 0.78 at 2 years, and 0.74 at 3 years, respectively, and the addition of PNI could significantly improve the predictive ability of the model incorporating traditional risk factors. In summary, PNI correlated with eGFR and glomerular injury and was an independent predictor for DN progression in patients with T2DM. Thus, it may facilitate the risk stratification of DN patients and contribute to targeted management. FAU - Zhang, Junlin AU - Zhang J AUID- ORCID: 0000-0002-7480-0612 AD - Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China. AD - Department of Nephrology, The Third People's Hospital of Chengdu, Chengdu 610014, China. AD - Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu 610041, China. FAU - Xiao, Xiang AU - Xiao X AD - Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China. AD - Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu 610041, China. AD - Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China. FAU - Wu, Yucheng AU - Wu Y AD - Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China. AD - Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu 610041, China. FAU - Yang, Jia AU - Yang J AD - Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China. AD - Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu 610041, China. FAU - Zou, Yutong AU - Zou Y AD - Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China. AD - Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu 610041, China. FAU - Zhao, Yuancheng AU - Zhao Y AD - Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China. AD - Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu 610041, China. FAU - Yang, Qing AU - Yang Q AD - Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China. AD - Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu 610041, China. FAU - Liu, Fang AU - Liu F AUID- ORCID: 0000-0003-1121-3004 AD - Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China. AD - Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu 610041, China. LA - eng GR - No.21ZD001/Health Commission of Sichuan Province Program/ PT - Journal Article DEP - 20220902 PL - Switzerland TA - Nutrients JT - Nutrients JID - 101521595 SB - IM MH - *Diabetes Mellitus, Type 2/complications MH - *Diabetic Nephropathies/diagnosis/etiology/pathology MH - Disease Progression MH - Glomerular Filtration Rate MH - Humans MH - *Kidney Failure, Chronic/etiology MH - Nutrition Assessment MH - Prognosis MH - Proteinuria/complications MH - Retrospective Studies PMC - PMC9460356 OTO - NOTNLM OT - diabetic nephropathy OT - end-stage renal disease OT - prognostic nutritional index OT - type 2 diabetes COIS- The authors declare no conflict of interest. EDAT- 2022/09/10 06:00 MHDA- 2022/09/14 06:00 PMCR- 2022/09/02 CRDT- 2022/09/09 01:25 PHST- 2022/07/15 00:00 [received] PHST- 2022/08/24 00:00 [revised] PHST- 2022/08/28 00:00 [accepted] PHST- 2022/09/09 01:25 [entrez] PHST- 2022/09/10 06:00 [pubmed] PHST- 2022/09/14 06:00 [medline] PHST- 2022/09/02 00:00 [pmc-release] AID - nu14173634 [pii] AID - nutrients-14-03634 [pii] AID - 10.3390/nu14173634 [doi] PST - epublish SO - Nutrients. 2022 Sep 2;14(17):3634. doi: 10.3390/nu14173634.