Analysis of risk factors for acute thrombosis of arteriovenous fistulae in patients undergoing mainte-nance hemodialysis and the construction of a Nomogram prediction model
10.7683/xxyxyxb.2024.05.013
- VernacularTitle:维持性血液透析尿毒症患者动静脉内瘘急性血栓形成的危险因素分析及Nomogram预测模型构建
- Author:
Yongxin GUO
1
;
Peiyun FENG
;
Wenling SHEN
;
Kun SUN
;
Yilong ZHOU
Author Information
1. 新乡医学院第三附属医院血液净化中心,河南 新乡 453003
- Keywords:
maintenance hemodialysis;
arteriovenous fistula;
acute thrombosis;
Nomogram prediction model
- From:
Journal of Xinxiang Medical College
2024;41(5):472-476
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors for acute thrombosis of arteriovenous fistulae(AF)in maintenance hemodialysis(MHD)patients and the construction of a Nomogram prediction model.Methods A total of 418 patients who underwent MHD treatment in the outpatient clinic of the Third Affiliated Hospital of Xinxiang Medical University from December 2020 to December 2022 were selected for the study.The patients were divided into the acute thrombosis group(n=32)and non-acute thrombosis group(n=386)according to whether acute thrombosis of AF was formed or not.The influencing factors affecting acute thrombosis of AF in MHD patients were analyzed using univariate and multivariate analysis.A Nomogram predic-tion model was established based on their independent risk factors,and Bootstrap was used to validate the efficacy of the Nomo-gram model.Results The complicated diabetes,complicated hypotension,puncture failure on dialysis,calcium-phosphorus product,hypersensitive C-reactive protein(hs-CRP),total cholesterol(TC),and low density lipoprotein-cholesterol(LDL-C)levels in patients in the acute thrombosis group were significantly higher than those in the non-acute thrombosis group(P＜0.05);logistic regression analysis showed that diabetes,hypotension,puncture failure on dialysis,calcium-phosphorus product elevation,high hs-CRP and high LDL-C level were the independent risk factors affecting acute thrombosis of AF in patients undergoing MHD(P＜0.05);the Nomogram model was constructed based on the 6 independent risk factors,and the consistency index(C-index)of the model was 0.893(95％confidence interval:0.833-0.928);in addition,its calibration curve and the standard curve were well fitted,the area under the curve was 0.918.Conclusion Diabetes,hypotension,puncture failure during dialysis,calcium-phosphorus product elevation,and high levels of hs-CRP and LDL-C are the risk factors for acute thrombosis of AF in patients undergoing MHD,and the Nomogram model constructed based on the independent risk factors has excellent predictive ability in predicting the occurrence of acute thrombosis of AF in patients undergoing MHD,which can help in the early screening of patients with high risk of clinical acute thrombosis.
