Background and Objectives: We aimed at evaluating the impact of Controlling Nutritional Status (CONUT) score on clinically significant decline in estimated glomerular filtration rate (eGFR) in patients with non-metastatic Clear Cell Renal Cell Carcinoma (ccRCC) undergoing radical nephrectomy (RN). Materials and methods: We retrospectively analyzed a multi-institutional cohort of 140 patients with ccRCC who underwent RN between 2016 and 2018 at three Urological Centers. The CONUT score was calculated with an algorithm including serum albumin, total lymphocyte count, and cholesterol. Clinical and pathologic features were analyzed using Fisher’s exact test for categorical variables and a Mann–Whitney U test for continuous variables. To define the independent predictors of clinically significant eGFR decline, univariable (UVA) and multivariable (MVA) binomial logistic regression analyses were performed in order to assess the Odds Ratio (OR) with 95% Confidence Intervals (CIs). Results: The optimal cut-off value to discriminate between a low and high CONUT score was assessed by calculating the ROC curve. The area under the curve (AUC) was 0.67 (95%CI 0.59–0.78) with the most appropriate cut-off value at 2 points. Overall, 46 patients (32.9%) had a high CONUT score (>2). Statistically significant variables associated with eGFR decline at 24 months were age ≥ 70 (OR 2.01; 95%CI 1.17–3.09;p0.05), stage II–III chronic kidney disease (CKD) (OR 6.05; 95%CI 1.79–28.3;p0.001), and a high CONUT score (OR 3.98; 95%CI 1.58–10.4;p0.004). Conclusions: The CONUT score is a low-time-consuming, cost-effective, and promising tool able to preoperatively screen patients at risk of developing CKD after a RN.
背景与目的：本研究旨在评估控制营养状况（CONUT）评分对接受根治性肾切除术（RN）的非转移性透明细胞肾细胞癌（ccRCC）患者估算肾小球滤过率（eGFR）发生临床显著性下降的影响。材料与方法：我们回顾性分析了2016年至2018年间在三个泌尿外科中心接受RN的140例ccRCC患者的多机构队列数据。CONUT评分通过包含血清白蛋白、总淋巴细胞计数和胆固醇的算法计算得出。分类变量采用Fisher精确检验进行分析，连续变量采用Mann-Whitney U检验进行分析。为确定临床显著性eGFR下降的独立预测因素，我们进行了单变量（UVA）和多变量（MVA）二项逻辑回归分析，以评估比值比（OR）及其95%置信区间（CIs）。结果：通过计算ROC曲线评估了区分低CONUT评分和高CONUT评分的最佳截断值。曲线下面积（AUC）为0.67（95%CI 0.59–0.78），最合适的截断值为2分。总体而言，46例患者（32.9%）具有高CONUT评分（>2分）。与24个月时eGFR下降相关的统计学显著变量包括：年龄≥70岁（OR 2.01；95%CI 1.17–3.09；p<0.05）、II–III期慢性肾脏病（CKD）（OR 6.05；95%CI 1.79–28.3；p<0.001）以及高CONUT评分（OR 3.98；95%CI 1.58–10.4；p<0.004）。结论：CONUT评分是一种耗时短、成本效益高且前景广阔的工具，能够在术前筛查出RN后存在发生CKD风险的患者。
肿瘤(癌症)患者之家