Beberashvili Ilia, Shaheen Khieralla, Nizri Elad, Stav Kobi, Efrati Shai
Nephrology Division, Yitzhak Shamir Medical Center, Zerifin, Israel.
Internal Department D, Yitzhak Shamir Medical Center, Zerifin, Israel.
Sci Rep. 2025 Apr 30;15(1):15235. doi: 10.1038/s41598-025-99584-7.
Our study analyzed 831 non-dialysis chronic kidney disease (CKD) patients admitted from January 2007 to January 2023, using 665 for creating and 166 for validating the CKD-Infectious Inflammation (CKD-INF) score. This score distinguishes inflammation types using logistic regression outcomes and aligns with the International Sepsis Definition Conference criteria. The study's participants had an average age of 76.2 ± 11.2 years, with 37% female and over half diagnosed with diabetes. The resulting score was as follows:[Formula: see text] where NLR refers to the neutrophil-to-lymphocyte ratio, CRP to C-reactive protein, and WBC indicates white blood cell count. CKD-INF exhibited a higher AUC of 0.85 (with a 95% CI of 0.82-0.87), higher sensitivity (75.3%) and specificity (82%) compared to its components including CRP. The CKD-INF score showed higher weighted κ values (0.57) for infection prediction at hospital admission than its individual components. In both training and validation groups, the CKD-INF score outperformed CRP as a predictor of infection in univariate and multivariate analyses. The CKD-INF score, derived from routine laboratory tests, can be an effective tool for predicting infections in CKD patients, potentially aiding in their early management.
我们的研究分析了2007年1月至2023年1月收治的831例非透析慢性肾脏病（CKD）患者，其中665例用于创建慢性肾脏病-感染性炎症（CKD-INF）评分，166例用于验证该评分。该评分利用逻辑回归结果区分炎症类型，并符合国际脓毒症定义会议标准。研究参与者的平均年龄为76.2±11.2岁，37%为女性，超过半数被诊断为糖尿病。最终得出的评分如下：[公式：见正文]，其中NLR指中性粒细胞与淋巴细胞比值，CRP指C反应蛋白，WBC表示白细胞计数。与包括CRP在内的各个组成部分相比，CKD-INF的曲线下面积（AUC）更高，为0.85（95%置信区间为0.82-0.87），敏感性更高（75.3%），特异性更高（82%）。CKD-INF评分在预测入院时的感染方面，其加权κ值（0.57）高于各个组成部分。在训练组和验证组中，在单变量和多变量分析中，CKD-INF评分作为感染预测指标均优于CRP。源自常规实验室检查的CKD-INF评分可以成为预测CKD患者感染的有效工具，可能有助于对其进行早期管理。
