PNI = Alb(g/L) + 5×TLC(×10⁹/L) Onodera 1984 Buzby 1980 GPS · CONUT · GNRI NLR · PLR · SII · CAR

Prognostic
Nutritional
Index

PhD-grade dual-formula PNI · 9 oncology indices · Surgical risk stratification · ESPEN 2021 recommendations

9Indices
2PNI Formulas
40+Cancer Types
6Report Tabs
✓ Onodera PNI 1984 ✓ Buzby Surgical PNI 1980 ✓ Glasgow Prognostic Score ✓ ESPEN 2021 Oncology ✓ ISRNM · EWGSOP2 2019 ✓ GLIM 2019 ✓ AWGS 2019

PNI Clinical Assessment

Oncology & surgical nutrition · All computations are local & private

Rx Primary formula: PNI = Albumin(g/L) + 5 × TLC(×10⁹/L) — unit-equivalent to Onodera 1984 [10×Alb(g/dL) + 0.005×TLC(/mm³)]. GNRI also uses albumin in g/L (auto-converted). Buzby PNI requires transferrin + triceps skinfold.
1Patient Demographics & Oncology Profile
yrs
cm
kg
kg
2Primary Laboratory Values * required for PNI
g/dL
Converted to g/L (×10) for PNI formula. PNI uses g/L internally.
×10⁹/L
Enter in ×10⁹/L (SI). TLC = WBC × % Lymphocytes ÷ 100 ÷ 1000. PNI = Alb(g/L) + 5 × TLC(×10⁹/L).
×10⁹/L
NLR = Neutrophils ÷ Lymphocytes. SII = Plt × Neut ÷ Lymph (all ×10⁹/L).
×10⁹/L
Enter in ×10⁹/L (e.g. 250 for 250×10⁹/L). PLR = Plt ÷ Lymph.
mg/L
Required for GPS, mGPS, and CAR ratio.
mg/dL
Half-life 2d — acute depletion marker. PAR = Prealb ÷ CRP.
mg/dL
CONUT component. <100 mg/dL = severe depletion in cancer.
mg/dL
Required for Buzby 1980 surgical complication formula.
g/dL
g/dL
3Anthropometry & Functional Measures
mm
Posterior midpoint non-dominant arm. Required for Buzby PNI.
cm
cm
Sarcopenia marker. Cutoff ≥31 cm (AWGS 2019; Rolland 2003).
kg
EWGSOP2 2019: Male <27 kg · Female <16 kg = probable sarcopenia.
Candida / Mumps / Trichophyton antigen skin test.
4Dietary Intake & Symptom Burden
g/day
ESPEN 2021 oncology target: 1.2–2.0 g/kg/day. Surgery: 1.5–2.0 g/kg.
kcal/day
ESPEN 2021: 25–30 kcal/kg/day (increase to 30–35 if catabolic).

PNI = Alb(g/L) + 5×TLC(×10⁹/L) · Onodera 1984 · Buzby 1980 · GPS McMillan 2003 · CONUT Ulibarri 2005 · GNRI Bouillanne 2005 · NLR · PLR · SII Hu 2014 · CAR · PAR · ESPEN 2021

PNI = Alb(g/L) + 5×TLC
—
Enter albumin & TLC above
GPS—
NLR—
CONUT—
BMI—
INDICES COMPUTED
🔬
Onodera PNI (Primary)Alb(g/L) + 5×TLC(×10⁹/L) · oncology gold standard
🏥
Buzby PNI (Surgical)Pre-op complication prediction · 1980
📊
GPS / mGPSGlasgow Prognostic Score · systemic inflammation
🧪
CONUT ScoreAlb + Cholesterol + TLC · 0–12 scale
⚡
GNRIGeriatric Nutritional Risk Index · Bouillanne 2005
⚗️
NLR · PLR · SIIImmune-inflammation cancer prognostic indices
🔥
CAR · PARCRP/Albumin · Prealbumin/CRP inflammation ratios
💪
Sarcopenia ScreenEWGSOP2 grip + MAC + CC + weight loss
FORMULA REFERENCE
Onodera PNIAlb(g/L) + 5×TLC(×10⁹/L)
≡ Onodera (orig.)10×Alb(g/dL) + 0.005×TLC(/mm³)
Buzby PNI(%)158−16.6Alb−0.78TSF−0.2Transf−5.8DHR
GPSCRP >10 mg/L · Alb <3.5 g/dL
CONUTAlb(0–6) + Chol(0–3) + TLC(0–3)
GNRI1.489×Alb(g/L) + 41.7×(wt/IBW)
SII (×10⁹/L)Plt × Neut / Lymph [all ×10⁹/L]
CARCRP(mg/L) / Alb(g/dL)
CLINICAL SUPPORT

Oncology Dietitian
Consultation

ESPEN 2021-aligned MNT protocols, ONS optimisation, and serial PNI monitoring from our clinical team.

Book Consultation →
CLINICAL DISCLAIMER
⚕ For qualified clinicians only

This tool is intended exclusively for use by registered dietitians, oncologists, surgeons, and other qualified healthcare professionals. It is not suitable for use by patients, caregivers, or the general public without clinical supervision.

📊 Prognostic, not diagnostic

PNI and all associated indices are prognostic tools — they stratify risk and guide clinical decisions. They do not constitute a diagnosis of malnutrition, cancer, or any other condition. All results must be interpreted within the complete clinical, oncological, functional, and biochemical context of the individual patient.

🔬 Albumin is an acute-phase reactant

Serum albumin is suppressed by systemic inflammation independently of nutritional status. Low albumin in patients with elevated CRP may reflect disease burden rather than nutritional depletion. PNI may underestimate true nutritional risk in the presence of active inflammation (GPS 1–2). Prealbumin (half-life ~2 days) provides superior sensitivity for acute nutritional change.

🌍 Population-specific validation

PNI thresholds (≥45, 40–44, <40) were originally validated in Japanese gastric cancer surgical patients (Onodera 1984, n=205). External validation has been conducted across multiple cancer types and ethnicities; however, optimal cut-points may vary. GNRI Lorentz IBW equations and grip strength cutoffs are based on European and Asian cohorts — apply with caution in other populations.

📱 All calculations are client-side

No patient data is transmitted, stored, or processed on any external server. All computations run locally in the browser. This tool does not constitute a medical record or clinical document.

⚠ Not a substitute for clinical assessment

Serial PNI measurement, comprehensive nutritional assessment, and individualised medical nutrition therapy should always be conducted by a qualified clinician. This calculator supports — but does not replace — professional clinical judgement.

⚕ Onodera PNI validated in gastric (original, 1984), colorectal, lung, hepatic, oesophageal, pancreatic and bladder malignancies. GPS prospectively validated across 35+ solid tumour types (McMillan 2013). SII validated in hepatocellular carcinoma (Hu et al., Gut 2014) and extended across multiple solid tumour types. All calculations client-side. Not for self-diagnosis. For use by qualified clinicians only.