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预测造血干细胞移植后急性肾损伤的风险:新预测列线图的制定。

Predicting the risk of acute kidney injury after hematopoietic stem cell transplantation: development of a new predictive nomogram.

机构信息

Department of Hematology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China.

Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China.

出版信息

Sci Rep. 2022 Sep 12;12(1):15316. doi: 10.1038/s41598-022-19059-x.

Abstract

The purpose was to predict the risk of acute kidney injury (AKI) within 100 days after hematopoietic stem cell transplantation (HSCT) in patients with hematologic disease by using a new predictive nomogram. Collect clinical data of patients with hematologic disease undergoing HSCT in our hospital from August 2012 to March 2018. Parameters with non-zero coefficients were selected by the Least Absolute Selection Operator (LASSO). Then these parameters were selected to build a new predictive nomogram model. Receiver operating characteristic (ROC) curve, calibration curve, C-index, and decision curve analysis (DCA) were used for the validation of the evaluation model. Finally, the nomogram was further evaluated by internal verification. According to 2012 Kidney Disease Improving Global Guidelines (KDIGO) diagnostic criteria, among 144 patients, the occurrence of AKI within 100 days after HSCT The rate was 29.2% (42/144). The C-index of the nomogram was 0.842. The C-value calculated by the internal verification was 0.809. The AUC was 0.842, and The DCA range of the predicted nomogram was from 0.01 to 0.71. This article established a high-precision nomogram for the first time for predicting the risk of AKI within 100 days after HSCT in patients with hematologic diseases. The nomogram had good clinical validity and reliability. For clinicians, it was very important to prevent AKI after HSCT.

摘要

目的是通过建立新的预测列线图模型,预测血液病患者造血干细胞移植(HSCT)后 100 天内急性肾损伤(AKI)的风险。收集 2012 年 8 月至 2018 年 3 月在我院行 HSCT 的血液病患者的临床资料。采用最小绝对值选择算子(LASSO)选择非零系数的参数。然后,选择这些参数来构建新的预测列线图模型。通过接受者操作特征(ROC)曲线、校准曲线、C 指数和决策曲线分析(DCA)对评估模型进行验证。最后,通过内部验证进一步评估列线图。根据 2012 年肾脏病改善全球指南(KDIGO)诊断标准,在 144 例患者中,HSCT 后 100 天内 AKI 的发生率为 29.2%(42/144)。列线图的 C 指数为 0.842。内部验证计算的 C 值为 0.809。AUC 为 0.842,预测列线图的 DCA 范围为 0.01 至 0.71。本文首次建立了预测血液病患者 HSCT 后 100 天内 AKI 风险的高精度列线图。该列线图具有良好的临床有效性和可靠性。对于临床医生来说,预防 HSCT 后 AKI 非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed91/9468340/2c4c474d63b4/41598_2022_19059_Fig1_HTML.jpg

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