Wang Bin, Zheng Xie, Fu Qinghui, Luo Xiaoqian, Pan Sijun
The Department of Emergency, People's Hospital of Anji, Anji, Zhejiang, China.
The Department of SICU, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Biomark Med. 2025 Jun;19(12):491-499. doi: 10.1080/17520363.2025.2520738. Epub 2025 Jun 16.
Type 2 CRS is characterized by the development of renal dysfunction secondary to chronic cardiac disease. Despite its high morbidity and mortality, there is a lack of robust diagnostic tools and prognostic models to guide clinical management.
This multicenter retrospective study included patients diagnosed with CRS type 2 based on the 2019 American Heart Association definition. Data were collected from electronic medical records of three hospitals between January 2021 and December 2023. Advanced statistical methods, including receiver operating characteristic (ROC) curve analysis, univariate Kaplan-Meier (KM) analysis, and multivariable Cox proportional hazards regression, were utilized to develop a nomogram for predicting patient prognosis.
The study included 519 patients with CRS-2. Independent predictors of adverse outcomes included elevated serum creatinine and blood urea nitrogen (BUN) levels, decreased platelet count, elevated B-type natriuretic peptide (BNP), and decreased oxygen partial pressure (PaO2). These findings suggest that close monitoring of these markers is essential in clinical practice to identify patients at high risk of adverse events early on.
Our study provides evidence that serum creatinine, BUN, platelet count, BNP, and PaO2 are independent predictors of adverse outcomes in patients with Type 2 CRS.
2型心肾综合征的特征是继发于慢性心脏疾病的肾功能障碍。尽管其发病率和死亡率很高,但缺乏强有力的诊断工具和预后模型来指导临床管理。
这项多中心回顾性研究纳入了根据2019年美国心脏协会定义诊断为2型心肾综合征的患者。数据收集自2021年1月至2023年12月期间三家医院的电子病历。采用包括受试者工作特征(ROC)曲线分析、单变量Kaplan-Meier(KM)分析和多变量Cox比例风险回归在内的先进统计方法,开发了一个预测患者预后的列线图。
该研究纳入了519例2型心肾综合征患者。不良结局的独立预测因素包括血清肌酐和血尿素氮(BUN)水平升高、血小板计数降低、B型利钠肽(BNP)升高和氧分压(PaO2)降低。这些发现表明,在临床实践中密切监测这些指标对于早期识别不良事件高危患者至关重要。
我们的研究提供了证据,表明血清肌酐、BUN、血小板计数、BNP和PaO2是2型心肾综合征患者不良结局的独立预测因素。