Luo Jie, Rui Zhangru, He Yun, Li Hui, Yuan Yang, Li Wenhong
YAN'AN Hospital of Kunming City, Kunming 650051, China.
Am Heart J Plus. 2024 Dec 2;49:100487. doi: 10.1016/j.ahjo.2024.100487. eCollection 2025 Jan.
Chronic kidney disease (CKD) is expected to become the fifth leading cause of death globally by 2040. Cardiovascular disease (CVD), particularly heart failure (HF), is a severe complication in CKD patients on hemodialysis. This study aimed to develop a nomogram to predict the risk of heart failure hospitalization in hemodialysis patients, providing a valuable tool for clinical decision-making. We retrospectively analyzed data from 196 patients at Kunming Yanan Hospital's hemodialysis center, including demographic, dialysis-related, and laboratory information. Significant HF predictors identified through univariate and multivariate logistic regression were age, diabetes, dialysis duration, left ventricular mass index (LVMI), albumin (ALB), and ejection fraction (EF). These predictors formed the basis of the nomogram, which demonstrated good discrimination (AUC = 0.728) and calibration (Hosmer-Lemeshow test, = 0.463). Decision curve analysis confirmed the nomogram's clinical utility across various threshold probabilities. This study's findings can help clinicians identify high-risk patients, improving management strategies and potentially reducing HF-related hospitalizations in the hemodialysis population.
预计到2040年，慢性肾脏病（CKD）将成为全球第五大死因。心血管疾病（CVD），尤其是心力衰竭（HF），是接受血液透析的CKD患者的严重并发症。本研究旨在开发一种列线图，以预测血液透析患者心力衰竭住院风险，为临床决策提供有价值的工具。我们回顾性分析了昆明延安医院血液透析中心196例患者的数据，包括人口统计学、透析相关和实验室信息。通过单因素和多因素逻辑回归确定的显著HF预测因素为年龄、糖尿病、透析时间、左心室质量指数（LVMI）、白蛋白（ALB）和射血分数（EF）。这些预测因素构成了列线图的基础，该列线图显示出良好的区分度（AUC = 0.728）和校准度（Hosmer-Lemeshow检验，= 0.463）。决策曲线分析证实了列线图在各种阈值概率下的临床实用性。本研究结果可帮助临床医生识别高危患者，改善管理策略，并可能减少血液透析人群中与HF相关的住院率。
