The Hemodialysis Prognostic Nutrition Index (HD-PNI) can be used to identify hemodialyis patients at increased risk due to poor nutrition. Data collected over an 8 month baseline period is used to predict outcomes over the subsequent 3 month period.
Patient selection: adult >= 18 years of age who is undergoing hemodialysis for a period of at least 3 months.
Parameters:
(1) mean serum albumin in g/dL
(2) number of times hospitalized
(3) mean serum creatinine change in mg/dL
(4) number of days hospitalized
HD-PNI =
= 3.33 – (1.060 * (mean serum albumin in g/dL)) + (0.514 * (number of times hospitalized)) + (0.180 * (mean serum creatinine change in mg/dL)) + (0.040 * (number of days hospitalized))
where:
• In calculating length of hospitalization the day of admission and day of discharge were considered as 1 day.
• The laboratory data apparently is collected monthly. In the implementation I have assumed 8 separate values for albumin and creatinine, 1 for each month.
Interpretation:
• A HD-PNI >= 0.8 identified patients at nutritional risk.
Outcomes
HD-PNI < 0.8
HD-PNI >= 0.8
hospitalized
28.5%
57.2%
infection
4.6%
14.6%
death
2.5%
7.7%
from Figure 2 page 5, Beto (1999)
To read more or access our algorithms and calculators, please log in or register.
