Objective:

To investigate the prognostic relevance of the Controlling Nutritional Status (CONUT) score and the Aggregate Index of Systemic Inflammation (AISI) for predicting all-cause mortality (ACM) in patients undergoing maintenance hemodialysis (MHD), and to identify independent prognostic indicators to aid clinical risk categorization and tailored therapeutic interventions.

Approach:

Key Findings:

• ROC analysis showed AUC of 0.704 for CONUT score and 0.694 for AISI in a cohort of 614 patients.
• Optimal threshold values were identified at 3.5 for CONUT and 306.100 for AISI.
• Patients with AISI < 306.100 had better cumulative survival rates (p < 0.001).
• Patients with CONUT score ≥ 3.5 had significantly reduced cumulative survival (p < 0.001).
• Independent factors associated with increased five-year ACM included CVC utilization, CONUT score ≥ 3.5, AISI ≥ 306.100, and elevated AST levels.

Interpretation:

Both AISI and CONUT score provide significant prognostic information for predicting ACM in MHD patients, aiding in identifying high-risk individuals and informing clinical decision-making.

Conclusion:

The combined use of AISI and CONUT score is a robust tool for identifying high-risk individuals in the MHD population, emphasizing the need for clinical integration.

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