A higher prognostic nutritional index is inversely associated with the need for renal replacement therapy in elderly critically Ill surgical patients.

The results strongly support our original conclusions: PNI is a highly significant protective factor against RRT after adjusting for multiple covariates such as age, sex, comorbidities, and disease severity, every 10-unit increase in PNI was associated with an OR of 0.54 (95% CI: 0.45–0.66, p < 0.0001) for the outcome "RRT" compared to "no event."PNI also serves as a protective factor against mortality (OR = 0.73, P < 0.0001), confirming that death is indeed a competing event associated with PNI.It is noteworthy that the strength of the association between PNI and RRT (OR = 0.54) is even greater than its association with mortality (OR = 0.73).

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