PNI, CONUT, and GNRI for predicting treatment failure in peritoneal dialysis-associated peritonitis: a two-center retrospective study

Peritoneal dialysis-associated peritonitis (PDAP) is one of the common causes of technique failure in patients undergoing peritoneal dialysis. It may also affect long-term survival. Early identification of patients with a high risk of treatment failure is therefore important in clinical practice. Malnutrition has been reported to be related to poor outcomes in PDAP, but the predictive value of different nutritional scores has not been fully compared. The Prognostic Nutritional Index (PNI), the Controlling Nutritional Status (CONUT) score, and the Geriatric Nutritional Risk Index (GNRI) are commonly used nutritional scores to evaluate nutritional status. However, their predictive value for PDAP treatment failure has not been fully compared. This two-center retrospective study aimed to investigate the predictive value of PNI, CONUT, and GNRI for PDAP treatment failure. A total of 393 patients with PDAP were included in the study. The rate of treatment failure was 30.79%. The results showed that PNI had the highest predictive value, with an area under the curve (AUC) of 0.712. The AUCs of CONUT and GNRI were 0.681 and 0.633, respectively. All three nutritional scores showed linear dose-response relationships with treatment failure. PNI, CONUT, and GNRI were identified as independent predictors in multivariable-adjusted analyses. Subgroup analyses were further performed to test the stability of the results. The study found that PNI, CONUT, and GNRI can be useful tools for predicting treatment failure in PDAP. However, further studies are needed to confirm these findings and to explore the underlying mechanisms. In conclusion, this study highlights the importance of nutritional status in predicting treatment failure in PDAP. Clinicians should consider using PNI, CONUT, and GNRI as part of their risk assessment for PDAP treatment failure. However, it is essential to note that this study was a retrospective analysis and had limitations. Therefore, the results should be interpreted with caution and further studies are needed to confirm the findings.