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揭示风险因素:腹膜透析患者频繁腹膜炎的预后模型

Unveiling risk factors: a prognostic model of frequent peritonitis in peritoneal dialysis patients.

作者信息

Xu Qi-Jiang, Zang Zhi-Yun, Zhou Xue-Li, Ma Ni-Ya, Pu Li, Li Zi

机构信息

Department of Nephrology, Institute of Nephrology, West China Hospital of Sichuan University, Chengdu, China.

Department of Nephrology, Yibin Second People's Hospital, Yibin, China.

出版信息

Front Med (Lausanne). 2025 Jan 29;12:1456857. doi: 10.3389/fmed.2025.1456857. eCollection 2025.

DOI:10.3389/fmed.2025.1456857
PMID:39944488
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11814443/
Abstract

INTRODUCTION

Peritoneal dialysis-associated peritonitis (PDAP) is a serious complication of peritoneal dialysis (PD) patients. The aim of this study was to construct a risk prediction model for frequent episodes in PDAP patients.

METHODS

This retrospective cohort study included PDAP patients in our center from January 1, 2010 to December 31, 2021. The risk prediction model for frequent episodes in PDAP patients was constructed by the binary logistic regression.

RESULTS

We included 371 PDAP patients, of which 235 patients had single episode and 136 had frequent episodes. We randomly allocated the patients into training set (296 patients) and test set (75 patients) in the ratio of 8:2. In the training set, we found several independent risk factors significantly associated with frequent episodes in PDAP patients, including diabetes mellitus (DM), hemoglobin (HB), serum albumin (ALB), lactatic dehydrogenase (LDH), serum potassium (K), N-terminal pro-brain natriuretic peptide (NT-proBNP) and peritoneal dialysate white cell counts on day 1. And we constructed a prediction model with an area under curve (AUC) values of 0.75 in the training set and 0.76 in the test set, which showed excellent predictive performance.

CONCLUSION

We constructed a predictive model that demonstrated excellent predictive performance for identifying high-risk frequent episodes in PDAP patients and developed a more intuitive nomogram for evaluating the risk. However, multicenter studies with a larger sample size are warranted to validate the model in the future.

摘要

引言

腹膜透析相关腹膜炎(PDAP)是腹膜透析(PD)患者的一种严重并发症。本研究的目的是构建一个预测PDAP患者频繁发作的风险预测模型。

方法

这项回顾性队列研究纳入了2010年1月1日至2021年12月31日在本中心的PDAP患者。通过二元逻辑回归构建PDAP患者频繁发作的风险预测模型。

结果

我们纳入了371例PDAP患者,其中235例为单次发作,136例为频繁发作。我们将患者按8:2的比例随机分为训练集(296例患者)和测试集(75例患者)。在训练集中,我们发现了几个与PDAP患者频繁发作显著相关的独立危险因素,包括糖尿病(DM)、血红蛋白(HB)、血清白蛋白(ALB)、乳酸脱氢酶(LDH)、血清钾(K)、N末端脑钠肽前体(NT-proBNP)和第1天的腹膜透析液白细胞计数。我们构建了一个预测模型,训练集的曲线下面积(AUC)值为0.75,测试集为0.76,显示出优异的预测性能。

结论

我们构建了一个预测模型,该模型在识别PDAP患者高风险频繁发作方面表现出优异的预测性能,并开发了一个更直观的列线图来评估风险。然而,未来需要进行更大样本量的多中心研究来验证该模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4d/11814443/5d38f51b372b/fmed-12-1456857-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4d/11814443/546fcd6b47df/fmed-12-1456857-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4d/11814443/a1f7ce757839/fmed-12-1456857-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4d/11814443/c423e159686a/fmed-12-1456857-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4d/11814443/5d38f51b372b/fmed-12-1456857-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4d/11814443/546fcd6b47df/fmed-12-1456857-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4d/11814443/a1f7ce757839/fmed-12-1456857-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4d/11814443/c423e159686a/fmed-12-1456857-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4d/11814443/5d38f51b372b/fmed-12-1456857-g004.jpg

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本文引用的文献

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Peritoneal Fluid Analysis in Peritoneal Dialysis-Associated Peritonitis.腹膜透析相关性腹膜炎的腹腔积液分析
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