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. 2025 Jul 7:18:3775-3786.
doi: 10.2147/IJGM.S533080. eCollection 2025.

Does Control Nutritional Status (CONUT) Score Predict Early and Long-Term Mortality at the Initiation of Maintenance Hemodialysis?

Tamer Selen  1 , Gülay Ulusal Okyay  2 , Fatma Ayerden Ebinç  2 , Özgür Merhametsiz  3 , Hatice Şahin  2 , Mehmet Deniz Aylı  2
Affiliations

Does Control Nutritional Status (CONUT) Score Predict Early and Long-Term Mortality at the Initiation of Maintenance Hemodialysis?

Tamer Selen et al. Int J Gen Med. .

Abstract

Purpose: Controlled Nutritional Status (CONUT) score is strongly associated with mortality in various patient groups. This study aimed to assess the CONUT score's ability to predict mortality in Hemodialysis (HD) patients.

Patients and methods: Data from 243 patients who started HD between 2012 and 2020 were analyzed retrospectively. Laboratory test results within the first month after dialysis initiation were recorded and CONUT scores were calculated.

Results: Over a mean follow-up duration of 32.2 months, the association between early (within six months) and late mortality was assessed. During this period, 119 patients (48.8%) died. Non-survivors had higher CONUT scores. The optimal cut-off for the CONUT score was 5.5. Sensitivity and specificity for predicting mortality were 62.2% and 61.23%, respectively. The optimal cut-off for early mortality was 6.5. Sensitivity and specificity for predicting early mortality were 68% and 69.3%, respectively. The CONUT score demonstrated moderate predictive accuracy for mortality (AUC 0.665) and higher accuracy for early mortality (AUC 0.729), highlighting its clinical utility in risk stratification.

Conclusion: CONUT score at the beginning of HD is a reliable tool in predicting overall mortality in these patients, but it is especially useful in predicting early mortality.

Keywords: CONUT score; hemodialysis; malnutrition; mortality.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
CONUT score calculation.
Figure 2
Figure 2
ROC curve for CONUT score. AUC 0.665 (CI 95% 0.596–0.733) and p<0.001. Statistically significant cut-off value 5.5 (sensitivity 62.2%, specificity 61.23%).
Figure 3
Figure 3
Kaplan Meier Survival curve according to CONUT threshold value. Positive predictive value was 60% and the negative predictive value was 62.8%. Kaplan Meier Survival curve according to the CONUT cut-off value (5.5) (log rank p < 0.001). CONUT<5.5 estimate 64.2 months (57–71.3); CONUT ≥5.5 estimate 41.6 months (35.5–47.7).
Figure 4
Figure 4
Early mortality ROC curve CONUT. AUC 0.729 (CI 95% 0.628–0.830) and p<0.001. Statistically significant cut-off value 6.5 (sensitivity 68%, specificity 69.3%).
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