Predictive value of the Naples Prognostic Score for rapid kidney function decline in stage 3-4 CKD: a multicenter...

Area of Science:

• Nephrology
• Internal Medicine
• Clinical Prediction Models

Background:

• Chronic kidney disease (CKD) management requires accurate prognostication.
• Identifying patients at risk for rapid kidney function decline (RKFD) is crucial for timely intervention.
• The Naples Prognostic Score (NPS) is a potential tool for assessing CKD progression.

Purpose of the Study:

• To evaluate the clinical utility of the Naples Prognostic Score (NPS) in predicting rapid 12-month kidney function decline (RKFD).
• To assess NPS performance in predialysis patients with stage 3-4 chronic kidney disease (CKD).

Main Methods:

• Retrospective analysis of 404 predialysis stage 3-4 CKD patients with at least 12 months of follow-up.
• RKFD defined as an absolute decrease in estimated glomerular filtration rate (eGFR) > 5 mL/min/1.73 m² over 12 months.
• Multivariable logistic regression and ROC curve analyses were used to assess NPS predictive performance.

Main Results:

• 26.0% of patients experienced RKFD.
• Patients with RKFD showed significantly worse inflammatory and nutritional markers (e.g., higher NLR, lower LMR, reduced albumin).
• NPS was independently associated with RKFD (OR=7.86) and demonstrated high discriminative performance (AUC=0.912).

Conclusions:

• The Naples Prognostic Score (NPS) is an independent predictor of short-term RKFD in stage 3-4 CKD patients.
• NPS shows significant discriminative ability, suggesting clinical relevance for identifying high-risk individuals.
• External validation in prospective studies is recommended to confirm these findings.