Impact of the prognostic nutritional index on renal replacement therapy–free survival and mortality in patients on continuous renal replacement therapy

Abstract The survival of critically ill patients with acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT) is highly dependent on their nutritional status. This retrospective cohort study investigated the correlation between the prognostic nutritional index (PNI) and clinical outcomes of critically ill patients with AKI receiving CRRT. We analyzed data from 2076 critically ill patients admitted to the intensive care unit at Changhua Christian Hospital, a tertiary hospital in central Taiwan, between January 1, 2010, and April 30, 2021. All these patients met the inclusion criteria of the study. Through Cox proportional hazard model and propensity score matching, the relationship between PNI and renal replacement therapy–free survival (RRTFS) and mortality was examined. The results revealed that patients in the high PNI group had significantly higher RRTFS rates and higher survival rates compared with those in the low PNI group. Although parenteral nutrition (PN) did not provide significant survival benefits, long-term PN may improve the nutritional status and reduce mortality in AKI patients on CRRT. Therefore, PNI, which measures albumin and lymphocytes, is a simple and effective method that can be used to assess nutritional status and predict outcomes in clinical settings.