Xian Zhurui, Song Xiaofei, Wang Yongfu, Yang Tingting, Mao Nan
Nephrology Department, Public Health Clinical Center of Chengdu, First Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Nephrology Department, Public Health Clinical Center of Chengdu, Chengdu, China.
Ren Fail. 2025 Dec;47(1):2461665. doi: 10.1080/0886022X.2025.2461665. Epub 2025 Feb 17.
This single-center retrospective study aimed to explore the 1-year mortality risk factors in 166 patients with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) undergoing maintenance hemodialysis (MH) between 6 June 2017 and 6 June 2023, and construct a 1-year mortality prediction model. The patients were classified into survival and mortality groups based on the 1-year follow-up results, and into training and validation sets at a ratio of 1:1 (53 mortalities and 53 survivors in the training set and 48 mortalities and 58 survivors in the validation set). Stepwise logistic regression was used to construct a 1-year mortality prediction model and to visualize it as a nomogram. Receiver operating characteristic (ROC) analysis, calibration curves, and decision curves were used for nomogram evaluation in the training set and validation in the validation set. Age (≥52 years) (OR (95% CI): 2.05 (3.191-18.892), ), neutrophil to albumin ratio (NAR) (≥0.135) (OR (95% CI): 4.753 (2.011-11.234), ), and HIV-RNA (≥24,650) (OR (95% CI): 13.786 (5.493-34.598), ), represents three of five independent risk factors of 1-year mortality in HIV/AIDS undergoing MH. The AUC of the nomogram for the training and validation sets were 0.908 (95% CI: 0.853-0.963) and 0.939 (95% CI: 0.896-0.983), respectively. The 1-year mortality prediction showed good separation capacity, calibration capacity, and clinical net benefit, which may benefit the management of patients with HIV/AIDS undergoing MH.
本单中心回顾性研究旨在探讨2017年6月6日至2023年6月6日期间166例接受维持性血液透析(MH)的人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)患者的1年死亡风险因素,并构建1年死亡预测模型。根据1年随访结果将患者分为生存组和死亡组,并按1:1的比例分为训练集和验证集(训练集53例死亡患者和五十三个幸存者,验证集48例死亡患者和58例幸存者)。采用逐步逻辑回归构建1年死亡预测模型,并将其可视化为列线图。在训练集中使用受试者工作特征(ROC)分析、校准曲线和决策曲线进行列线图评估,在验证集中进行验证。年龄(≥52岁)(OR(95%CI):2.05(3.191-18.892))、中性粒细胞与白蛋白比值(NAR)(≥0.135)(OR(95%CI):4.753(2.011-11.234))和HIV-RNA(≥24,650)(OR(95%CI):13.786(5.493-34.598))是接受MH的HIV/AIDS患者1年死亡的五个独立风险因素中的三个。训练集和验证集列线图的AUC分别为0.908(95%CI:0.853-0.963)和0.939(95%CI:0.896-0.983)。1年死亡预测显示出良好的区分能力、校准能力和临床净效益,这可能有利于接受MH的HIV/AIDS患者的管理。