THE SIGNIFICANCE OF DETERMINING IMMUNO-NUTRITIONAL INDEXES IN THE ASSESSMENT OF LUPUS NEPHRITIS ACTIVITY

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https://storage.unitedwebnetwork.com/files/1099/4d2d1f78e0bc5a893abe44d5f13592a7.pdf

Abstract Title

First Name *

Violeta

Last Name *

Rabrenovic

Co-author 1

Nemanja Rancic nece84@hotmail.com Military Medical Academy Center for Clinical Pharmacology Belgrade

Co-author 2

Milica Petrovic drmilicapetrovic@gmail.com Military Medical Academy Clinic of nephrology Belgrade

Co-author 3

Milorad Rabrenovic miloradrabrenovic@gmail.com Military Medical Academy Centar of hyperbaric medicine, Belgrade

Co-author 4

Dejan Pilcevic dejan.pilcevic@gmail.com Military Medical Academy Clinic of nephrology Belgrade

Co-author 5

Neven Vavic nvavic@gmail.com Military Medical Academy Clinic of nephrology Belgrade

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Assessment of nutritional status is an important prognostic parameter in many diseases. Lupus nephritis (LN) as the most serious manifestation of systemic lupus erythematosus and a chronic immuno-inflammatory disease is associated with nutritional status disorders. The aim of this study was to determine: Nutritional risk index (NRI), Prognostic nutritional index (PNI) and Control nutritional status (CONUT), to determine their significance and association with active LN.

Methods

The study included 49 patients with LN, of which 26 were with active disease (Group 1), and 23 with LN in remission (Group 2). In addition to standard laboratory parameters, derived parameters were also determined: NRI = (1.519 × serum albumin, g/dL) + [41.7 × weight (kg)/ideal body weight (IBW; kg)].PNI=10 x serum albumin value (g/dL) + 0.005x peripheral lymphocyte count (/mm3). CONUT score =Serum albumin score + total lymphocyte score + total cholesterol score (score 0–1 :normal nutritional status, CONUT score 2–4: mild a moderate degree of malnutrition, and those with a CONUT score of 9–12 have a severe degree of malnutrition).

Results

A statistically significant difference (p=0.015) was obtained for PNI between groups (Group 1: Group 2 = 62.99 ±15.78 : 73.36 ±12.61). CONUT score was significantly different between groups Group 1: Group 2 = median 3:1 (p<0.001). No significant difference was observed for NRI. In the correlations, significant values were obtained both in the total group and in the group with active LN between NRI and creatinine (p= 0.005) and GFR (p= 0.002; p= 0.010), for PNI with anti ds DNA Ab ( p= 0.001; p= 0.010) and albumin (p= 0.005; p= 0.030), CONUT with CRP (p= 0.017), with anti ds DNA Ab (p= 0.000; p= 0.013), and with albumin and proteinuria ( p=0.000). In the group in which the disease was in remission, significance was observed only for NRI with creatinine, PNI with proteinuria and for CONUT score with proteinuria and albumin.

Conclusions

In our group of patients, the nutritional indexes : CONUT and PNI showed a statistically significant difference between the groups, and their correlation with standard parameters of active disease was significant for most parameters.

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