Analysis of risk factors and development of a prediction model for acute kidney injury complicated by acute non-variceal upper gastrointestinal bleeding
10.3969/j.issn.1671-8348.2025.11.019
- VernacularTitle:急性非静脉曲张性上消化道出血患者并发急性肾损伤的危险因素分析及预测模型构建
- Author:
Lu LIU
1
;
Caihua DUAN
;
Guosheng XIA
;
Juan LIU
Author Information
1. 吉安市中心人民医院:消化内科,江西 吉安 343000
- Keywords:
acute nonvariceal upper gastrointestinal bleeding;
acute kidney injury;
risk factors;
nomo-gram;
prediction model
- From:
Chongqing Medicine
2025;54(11):2594-2599,2604
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors for acute kidney injury(AKI)in patients with acute non-variceal upper gastrointestinal bleeding(ANVUGIB)and establish a prediction model.Methods A total of 286 ANVUGIB patients admitted to our hospital from August 2021 to August 2024 were enrolled.Patients were divided into an observation group(with AKI,n=43)and a control group(without AKI,n=243).The influencing factors for AKI in ANVUGIB patients were analyzed,and a nomogram prediction model was con-structed to evaluate its predictive efficacy.Results Among 286 ANVUGIB patients,43 cases(15.03%)de-veloped AKI.Logistic regression analysis showed that platelet count had no significant effect on AKI compli-cation in ANVUGIB(P>0.05).Hemoglobin,albumin,and sodium were independent protective factors for AKI complication(P<0.05),while comorbid coronary heart disease,bleeding volume,blood transfusion,and risk grade were independent risk factors(P<0.05).The nomogram prediction model for AKI complication in ANVUGIB demonstrated good fit in the Hosmer-Lemeshow test.ROC curve analysis revealed an AUC of 0.908(95%CI:0.868 to 0.939),with a sensitivity of 83.72%and specificity of 84.77%.The calibration curve showed a Brier score of 0.075 and calibration slope of 0.808,indicating good calibration.Conclusion Comorbid coro-nary heart disease,bleeding volume,blood transfusion,risk grade,hemoglobin,albumin,and sodium are signif-icant influencing factors for AKI complication in ANVUGIB.The nomogram model based on these factors shows favorable predictive performance and serves as a reliable tool for AKI risk stratification in ANVUGIB patients,supporting early clinical intervention decisions.
