Meng Lingfei, Yang Liming, Zhu Xueyan, Zhang Xiaoxuan, Li Xinyang, Cheng Siyu, Guo Shizheng, Zhuang Xiaohua, Zou Hongbin, Cui Wenpeng
Department of Nephrology, The Second Hospital of Jilin University, Changchun, China.
Department of Nephrology, The First Hospital of Jilin University-The Eastern Division, Changchun, China.
Front Med (Lausanne). 2022 Apr 26;9:875154. doi: 10.3389/fmed.2022.875154. eCollection 2022.
Peritoneal dialysis (PD)-associated peritonitis (PDAP) is a severe complication of PD. It is an important issue about whether it can be cured. At present, there is no available prediction model for peritonitis cure. Therefore, this study aimed to develop and validate a prediction model for peritonitis cure in patients with PDAP.
Patients with PD who developed PDAP from four dialysis centers in Northeast China were followed up. According to the region of PD, data were divided into training and validation datasets. Initially, a nomogram for peritonitis cure was established based on the training dataset. Later, the nomogram performance was assessed by discrimination (C-statistic), calibration, and decision curves.
Totally, 1,011 episodes of peritonitis were included in the final analysis containing 765 in the training dataset and 246 in the validation dataset. During the follow-up period, peritonitis cure was reported in 615 cases from the training dataset and 198 from the validation dataset. Predictors incorporated in the final nomogram included PD duration, serum albumin, antibiotics prior to admission, white cell count in peritoneal dialysate on day 5 (/μl) ≥ 100/μl, and type of causative organisms. The C-statistic values were 0.756 (95% CI: 0.713-0.799) in the training dataset and 0.756 (95% CI: 0.681-0.831) in the validation dataset. The nomogram exhibited favorable performance in terms of calibration in both the training and validation datasets.
This study develops a practical and convenient nomogram for the prediction of peritonitis cure in patients with PDAP, which assists in clinical decision-making.
腹膜透析（PD）相关腹膜炎（PDAP）是PD的一种严重并发症。其能否治愈是一个重要问题。目前，尚无腹膜炎治愈的可用预测模型。因此，本研究旨在开发并验证PDAP患者腹膜炎治愈的预测模型。
对来自中国东北地区四个透析中心发生PDAP的PD患者进行随访。根据PD地区，将数据分为训练集和验证集。最初，基于训练集建立腹膜炎治愈的列线图。随后，通过区分度（C统计量）、校准和决策曲线评估列线图性能。
最终分析共纳入1011例腹膜炎发作病例，其中训练集765例，验证集246例。随访期间，训练集有615例、验证集有198例报告腹膜炎治愈。最终列线图纳入的预测因素包括PD持续时间、血清白蛋白、入院前使用的抗生素、第5天腹膜透析液白细胞计数（/μl）≥100/μl以及致病菌类型。训练集的C统计量值为0.756（95%CI：0.713 - 0.799），验证集为0.756（95%CI：0.681 - 0.831）。该列线图在训练集和验证集的校准方面均表现出良好性能。
本研究开发了一种实用且便捷的列线图，用于预测PDAP患者的腹膜炎治愈情况，有助于临床决策。
