PD404 - THE PROGNOSTIC NUTRITIONAL INDEX AND TIME TO REMISSION IN CHILDREN WITH NEPHROTIC SYNDROME

PD404

THE PROGNOSTIC NUTRITIONAL INDEX AND TIME TO REMISSION IN CHILDREN WITH NEPHROTIC SYNDROME

Z. Ozturk Yalcin^1,*, C. Oruc², C. Kaplan², E. G. Ozdemir², E. D. Kurt Sukur², B. Gulhan², F. Ozaltin², A. Duzova², A. Bayraktar-Ekincioglu¹

¹Deparment of Clinical Pharmacy, Faculty of Pharmacy, ²Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye

Rationale: Nutritional imbalances affect clinical outcomes in nephrotic syndrome (NS), but its impact on remission remains unclear (1). The prognostic nutritional index (PNI), reflecting nutritional and immune status (2),may provide a clinically relevant insight into remission. 

Methods: This retrospective study included pediatric patients with steroid-responsive NS at a tertiary center. PNI was calculated at relapse as 10×albumin (g/dL) + 0.005×lymphocyte count (10³ cells/μL). TTR, defined as urinary protein-to-creatinine ratio <0.20mg/mg, serum albumin >3.5g/dL. Patients were grouped by median PNI. Regression analysis was performed to evaluate other factors associated with TTR, including BMI z-score, diuretic use and albumin infusion.

Results: Twenty-three patients were included (mean age was 12.8 ± 3.6 years and 56.5% male). Mean BMI z-score was −0.85 ± 2.16.  Diuretic use was observed in 11 and albumin infusion was administered in 12 patients. Median TTR was 14 days (IQR 10.0–20.5), and median PNI was 38.2. PNI was inversely correlated with TTR (Spearman’s r =-0.709, p<0.001). Patients with low PNI had a significantly longer TTR compared to those with high PNI (21 vs 11 days,p= 0.010). Only PNI remained significantly associated with TTR (p = 0.001), while other variables were not. BMI z-score was significant in univariable analysis (p=0.021) but lost significance after multivariable adjustment (p=0.246).

Conclusion: Baseline PNI may serve as a simple and clinically useful predictive marker.

References: Lella G, Pecoraro L, Benetti E, Arnone O, Piacentini G, Brugnara M, et al. Nutritional Management of Idiopathic Nephrotic Syndrome in Pediatric Age. Medical Sciences. 2023;11.

Zhang X, Feng N, Du L, Chen L, Zhang N, Zhao S, et al. Association between prognostic nutritional index and asthma in US children and adolescents: a cross-sectional study. J Asthma. 2026;63(3):284-93.

Disclosure of Interest: None declared