Comparison of mNUTRIC Score and mnutric Score with Albumin in Predicting Outcome in CKD Patients

OBJECTIVE: To predict morbidity and outcomes using mNutric score vs. mNutric with albumin in CKD patients. MATERIALS AND METHODS: After approval from the ethical committee, a retrospective observational study was conducted. Data was collected from patients aged 40–70 years having stage 3 or stage 4 CKD with underlying diabetes and hypertension, admitted in the ICU at ABMH from 1st January to 15th November 2024. Patients having other associated comorbidities were excluded from the study. Data collection was done using the hospital's EMR system, which included patients demographic characteristics, lab investigations, need for new dialysis, vasopressors’ used, mNUTRIC score, SOFA score, need for ventilators, length of stay in ICU, and morbidity and mortality data, etc. STATISTICAL ANALYSIS: Continuous variables were summarized as mean ± SD. Chi-square tests, Mann-Whitney tests, Fisher's exact tests, and logistic regression analyses were used to compare the length of ICU stay, the need for ventilators, vasopressors, and mortality. RESULTS: A total of 45 patients were recruited for analysis with a mean ± SD age of 61.38 ± 6.5 years. m-NUTRIC score was high (>4) in 23 patients and low (<=4) in 22 patients. Patients with an m-NUTRIC score >4 and serum albumin <3.5 g/dL had a significantly higher length of ICU stay and hospital stay (p < 0.0001), requirement and duration of ventilatory support (p < 0.0001), requirement of vasopressors (p = 0.0002), mortality (p < 0.001), and mortality due to sepsis (p < 0.0001). DISCUSSIONS: The study highlighted that adding albumin to the mNUTRIC score significantly improves its predictive accuracy for morbidity and mortality in CKD patients with hypertension and diabetes. Higher scores were associated with worse outcomes, suggesting that malnutrition and hypoalbuminemia independently contribute to poor prognosis in CKD. The results reflect the critical impact of advanced CKD, comorbidities, and nutritional status on patient outcomes in the ICU. High mNUTRIC scores and low serum albumin levels were strongly associated with prolonged ICU stays, increased need and duration for ventilation and requirement of vasopressors, and higher mortality rates.(1–6) CONCLUSION: The combination of these parameters demonstrated superior predictive accuracy for adverse outcomes, emphasizing the importance of integrating nutritional and biochemical assessments into risk stratification and management strategies for critically ill CKD patients. These findings highlight the need for targeted interventions to address nutritional deficiencies and mitigate risk factors in this vulnerable population.