Department of Transplantation, The First Affiliated Hospital of Nanchang University, 17 Yongwai Zhengjie Street, Nanchang, 330006, Jiangxi, China.
BMC Nephrol. 2022 Aug 15;23(1):284. doi: 10.1186/s12882-022-02908-2.
Kidney transplantation is an effective treatment for end-stage renal disease (ESRD). Delayed graft function (DGF) is a common complication after kidney transplantation and exerts substantial effects on graft function and long-term graft survival. Therefore, the construction of an effective model to predict the occurrence of DGF is particularly important.
Seventy-one patients receiving their first kidney transplant at the First Affiliated Hospital of Nanchang University from October 2020 to October 2021 were enrolled in the discovery cohort. Based on clinical characteristics and serum markers, a logistic regression model was used to simulate the risk of DGF in the discovery cohort. The DGF prediction model was named the prediction system and was composed of risk factors related to DGF. Thirty-two patients receiving a kidney transplant at the First Affiliated Hospital of Nanchang University from October 2021 to February 2022 were enrolled in the validation cohort. The validation cohort was used to verify the accuracy and reliability of the prediction model.
Cold ischemia time (CIT), donor history of diabetes mellitus, donor interleukin-2 (IL-2) level and donor terminal creatinine level constitute the prediction system. In the validation test, the area under the receiver operating characteristic curve (AUC) was 0.867 for the prediction system, and good calibration of the model was confirmed in the validation cohort.
This study constructed a reliable and highly accurate prediction model that provides a practical tool for predicting DGF. Additionally, IL-2 participates in the kidney injury process and may be a potential marker of kidney injury.
肾移植是治疗终末期肾病(ESRD)的有效方法。延迟移植物功能(DGF)是肾移植后的常见并发症,对移植物功能和长期移植物存活有重大影响。因此,构建有效的 DGF 发生预测模型尤为重要。
纳入 2020 年 10 月至 2021 年 10 月在南昌大学第一附属医院接受首次肾移植的 71 例患者作为发现队列,基于临床特征和血清标志物,使用逻辑回归模型模拟发现队列中 DGF 的风险。DGF 预测模型命名为预测系统,由与 DGF 相关的危险因素组成。纳入 2021 年 10 月至 2022 年 2 月在南昌大学第一附属医院接受肾移植的 32 例患者作为验证队列,验证预测模型的准确性和可靠性。
冷缺血时间(CIT)、供者糖尿病史、供者白细胞介素-2(IL-2)水平和供者终末期肌酐水平构成预测系统。在验证试验中,预测系统的受试者工作特征曲线下面积(AUC)为 0.867,模型在验证队列中得到了良好的校准。
本研究构建了一个可靠且高度准确的预测模型,为预测 DGF 提供了一种实用工具。此外,IL-2 参与了肾损伤过程,可能是肾损伤的潜在标志物。