Zhang Lijuan, Tang Lan, Chen Siyu, Chen Chen, Peng Bin
Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China.
Physical Examination Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Int Urol Nephrol. 2023 Jun;55(6):1609-1617. doi: 10.1007/s11255-023-03470-y. Epub 2023 Jan 31.
Chronic kidney disease (CKD) has become a major public health problem across the globe, leading to various complications. This study aimed to construct a nomogram to predict the 4-year risk of CKD among Chinese adults.
The study was based on the China Health and Retirement Longitudinal Study (CHARLS). A total of 3562 participants with complete information in CHARLS2011 and CHARLS2015 were included, and further divided into the training cohort and the validation cohort by a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to select variables of the nomogram. The nomogram was evaluated by receiver-operating characteristic curve, calibration plots, and decision curve analysis (DCA).
In all, 2494 and 1068 participants were included in the training cohort and the validation cohort, respectively. A total of 413 participants developed CKD in the following 4 years. Five variables selected by multivariate logistic regression were incorporated in the nomogram, consisting of gender, hypertension, the estimated glomerular filtration rate (eGFR), hemoglobin, and Cystatin C. The area under curve was 0.809 and 0.837 in the training cohort and the validation cohort, respectively. The calibration plots showed agreement between the nomogram-predicted probability and the observed probability. DCA indicated that the nomogram had potential clinical use.
A predictive nomogram was established and internally validated in aid of identifying individuals at increased risk of CKD.
慢性肾脏病(CKD)已成为全球主要的公共卫生问题,会引发各种并发症。本研究旨在构建一种列线图,以预测中国成年人患CKD的4年风险。
本研究基于中国健康与养老追踪调查(CHARLS)。纳入了CHARLS2011和CHARLS2015中共有3562名信息完整的参与者,并按照7:3的比例进一步分为训练队列和验证队列。采用单因素和多因素逻辑回归分析来选择列线图的变量。通过受试者工作特征曲线、校准图和决策曲线分析(DCA)对列线图进行评估。
训练队列和验证队列分别纳入了2494名和1068名参与者。在接下来的4年中共有413名参与者患上了CKD。多因素逻辑回归选择的5个变量被纳入列线图,包括性别、高血压、估计肾小球滤过率(eGFR)、血红蛋白和胱抑素C。训练队列和验证队列的曲线下面积分别为0.809和0.837。校准图显示列线图预测概率与观察概率之间具有一致性。DCA表明该列线图具有潜在的临床应用价值。
建立了一种预测列线图并进行了内部验证,以帮助识别CKD风险增加的个体。