Department of Nephrology, The First Affiliated Hospital of Jinan University, Jinan University, 613 W. Huangpu Avenue, Guangzhou, 510632, Guangdong, China.
Department of General Practice, Puning People's Hospital, Puning, 515300, Guangdong, China.
Sci Rep. 2024 Jan 10;14(1):1025. doi: 10.1038/s41598-023-48275-2.
Vascular calcification (VC) is a common complication of chronic kidney disease (CKD) that has a detrimental effect on patients' survival and prognosis. The aim of this study was to develop and validate a practical and reliable prediction model for VC in CKD5 patients. The medical records of 544 CKD5 patients were reviewed retrospectively. Multivariate logistic regression analysis was used to identify the independent risk factors for vascular calcification in patients with CKD5 and then created a nomogram prediction model. The area under the receiver operating characteristic curve (AUC), Hosmer-Lemeshow test, and decision curve analysis (DCA) were used to assess model performance. The patients were split into groups with normal and high serum uric acid levels, and the factors influencing these levels were investigated. Age, BUN, SUA, P and TG were independent risk factors for vascular calcification in CKD5 patients in the modeling group (P < 0.05). In the internal validation, the results of model showed that the AUC was 0.917. No significant divergence between the predicted probability of the nomogram and the actual incidence rate (x = 5.406, P = 0.753) was revealed by the calibration plot and HL test, thus confirming that the calibration was satisfactory. The external validation also showed good discrimination (AUC = 0.973). The calibration chart and HL test also demonstrated good consistency. Besides, the correlation analysis of serum uric acid levels in all CKD5 patients revealed that elevated uric acid levels may be related to gender, BUN, P, and TG.
血管钙化(VC)是慢性肾脏病(CKD)的常见并发症,对患者的生存和预后有不良影响。本研究旨在建立和验证 CKD5 患者 VC 的实用且可靠的预测模型。回顾性分析了 544 例 CKD5 患者的病历。采用多变量逻辑回归分析确定 CKD5 患者血管钙化的独立危险因素,并建立列线图预测模型。采用接受者操作特征曲线(ROC)下面积(AUC)、Hosmer-Lemeshow 检验和决策曲线分析(DCA)评估模型性能。将患者分为血清尿酸水平正常和升高的两组,探讨影响这些水平的因素。在建模组中,年龄、BUN、SUA、P 和 TG 是 CKD5 患者血管钙化的独立危险因素(P < 0.05)。内部验证结果显示,模型的 AUC 为 0.917。校准图和 HL 检验显示,列线图预测概率与实际发生率之间无显著差异(x = 5.406,P = 0.753),表明校准效果满意。外部验证也显示出良好的判别能力(AUC = 0.973)。校准图和 HL 检验也显示出良好的一致性。此外,对所有 CKD5 患者的血清尿酸水平进行相关分析显示,尿酸水平升高可能与性别、BUN、P 和 TG 有关。
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