Huang Junmin, Hao Junfeng, Luo Huasheng, Chen Lu, Luo Hongying, Liu Huafeng, Xu Yongzhi, Wang Peng
Department of Nephrology, National Clinical Key Specialty Construction Program (2023), Institute of Nephrology, Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases, Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Ren Fail. 2025 Dec;47(1):2444396. doi: 10.1080/0886022X.2024.2444396. Epub 2025 Jan 14.
The mortality rate of patients undergoing maintenance hemodialysis (MHD) remains high. The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel biomarker that reflects inflammation, nutritional and immune status, all merged into one single derived parameter. No study has yet linked the CALLY index to survival in hemodialysis. This study aims to explore the correlation between the CALLY index and mortality in MHD patients, and develop and validate a nomogram to estimate the likelihood of death in this population.
This retrospective cohort study collected data from 436 patients and they were divided into survival group ( = 335) and non-survival group ( = 101). Multivariate logistic regression analysis was used to screen factors associated with death, and nomograms were developed to estimate the risk of death in MHD patients. The discrimination and calibration of nomograms were validated using the area under the receiver operating characteristic (ROC) curve (AUC) and calibration curve. In the study, stratification analysis and covariate adjustment were conducted to explore the correlation between the CALLY index and the mortality of MHD patients.
In the final model, logistic regression showed that the CALLY index, creatinine, triglycerides, dialysis duration, absolute neutrophil count, blood urea nitrogen, sodium and ferritin were variables associated with mortality in MHD patients. A nomogram was developed to assess the risk of death in MHD patients. The AUC of the model was 0.821 (95% CI: 0.778-0.861). The results of stratified analysis and calibration model showed that the CALLY index was a protective factor for maintaining the mortality of MHD patients.
The CALLY index is closely related to the mortality of MHD patients. A nomogram constructed based on CALLY index can effectively evaluate the mortality risk of MHD patients.
维持性血液透析（MHD）患者的死亡率仍然很高。C反应蛋白-白蛋白-淋巴细胞（CALLY）指数是一种反映炎症、营养和免疫状态的新型生物标志物，所有这些都合并为一个单一的派生参数。尚无研究将CALLY指数与血液透析患者的生存率联系起来。本研究旨在探讨CALLY指数与MHD患者死亡率之间的相关性，并开发和验证一种列线图以估计该人群的死亡可能性。
这项回顾性队列研究收集了436例患者的数据，将他们分为生存组（n = 335）和非生存组（n = 101）。采用多因素逻辑回归分析筛选与死亡相关的因素，并开发列线图以估计MHD患者的死亡风险。使用受试者工作特征（ROC）曲线下面积（AUC）和校准曲线对列线图的区分度和校准度进行验证。在研究中，进行分层分析和协变量调整以探讨CALLY指数与MHD患者死亡率之间的相关性。
在最终模型中，逻辑回归显示CALLY指数、肌酐、甘油三酯、透析时间、绝对中性粒细胞计数、血尿素氮、钠和铁蛋白是与MHD患者死亡率相关的变量。开发了一种列线图以评估MHD患者的死亡风险。该模型的AUC为0.821（95%CI：0.778 - 0.861）。分层分析和校准模型的结果表明，CALLY指数是维持MHD患者死亡率的保护因素。
CALLY指数与MHD患者的死亡率密切相关。基于CALLY指数构建的列线图可以有效评估MHD患者的死亡风险。
