Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of Nephrology, The First Affiliated Hospital, Nanchang University, Nanchang, China.
Int Urol Nephrol. 2022 Nov;54(11):3017-3024. doi: 10.1007/s11255-022-03233-1. Epub 2022 Jun 15.
As an indicator of nutrition and immunity, the prognostic value of the prognostic nutritional index (PNI) has been confirmed in various diseases. However, the relationship between PNI and the incidence of pneumonia in peritoneal dialysis (PD) patients remains unknown. The purpose of this study was to investigate the relationship between PNI and new-onset pneumonia in patients undergoing PD.
Thousand two hundred and nighty eight patients were enrolled in this multicenter retrospective study from February 1, 2010, to February 28, 2020. A total of 899 patients were included in the final statistical analysis. The patients were stratified into two groups by PNI quartiles. The primary endpoint was a new-onset pneumonia event. Cox regression model analysis was used to explore the association between PNI and the first occurrence of pneumonia.
During a mean follow-up of 41.43 months, 147 patients developed new-onset pneumonia. Kaplan-Meier survival curves showed a significant difference in the incidence of the first presentation of pneumonia between the two groups, that patients in the low PNI group had a higher risk of pneumonia (P = 0.016). By adjusting for demographic parameters, comorbidities, and laboratory indicators, the Cox regression model showed that the high PNI group had less risk compared to the low PNI group (HR 0.479 95% CI 0.297-0.772, P = 0.003). There were no interactions in the subgroups as follows: diabetes, hypertension, age, and sex.
Low PNI levels were independently associated with the first occurrence of pneumonia in PD patients. PNI was an independent predictor of new-onset pneumonia in PD patients.
作为营养和免疫的指标，预后营养指数（PNI）的预后价值已在各种疾病中得到证实。然而，PNI 与腹膜透析（PD）患者肺炎发生率之间的关系尚不清楚。本研究旨在探讨 PNI 与 PD 患者新发肺炎之间的关系。
本多中心回顾性研究于 2010 年 2 月 1 日至 2020 年 2 月 28 日纳入 1228 名患者。共有 899 名患者纳入最终统计分析。根据 PNI 四分位将患者分为两组。主要终点为新发肺炎事件。Cox 回归模型分析用于探讨 PNI 与肺炎首次发生之间的关系。
在平均 41.43 个月的随访期间，147 名患者发生新发肺炎。Kaplan-Meier 生存曲线显示两组之间肺炎首次发生的发生率存在显著差异，低 PNI 组患者发生肺炎的风险更高（P=0.016）。通过调整人口统计学参数、合并症和实验室指标，Cox 回归模型显示高 PNI 组的风险低于低 PNI 组（HR 0.479，95%CI 0.297-0.772，P=0.003）。在糖尿病、高血压、年龄和性别亚组中没有交互作用。
低 PNI 水平与 PD 患者肺炎的首次发生独立相关。PNI 是 PD 患者新发肺炎的独立预测因子。
