Analysis of risk factors for pulmonary artery hypertension in patients with maintenance peritoneal dialysis and establishment and verification of a nomogram
10.19405/j.cnki.issn1000-1492.2025.11.023
- VernacularTitle:维持性腹膜透析患者并发肺动脉高压 危险因素分析及其列线图预测模型的建立与验证
- Author:
Shuang Zu
1
;
Qiqi Yan
2
;
Le Yang
1
;
Huixian Li
1
;
Xiude Li
1
;
Yunshan Fan
1
;
Bao Zhang
1
;
Deguang Wang
2
Author Information
1. Dept of Clinical Nutriology , The First Afiliated Hospital of Anhui Medical University , Hefei 230022
2. Dept of Nephrology , The Second Afiliated Hospital of Anhui Medical University , Hefei 230601
- Publication Type:Journal Article
- Keywords:
maintenance peritoneal dialysis;
echocardiography;
pulmonary hypertension;
constituent analysis;
fluid compartments;
nomograms
- From:
Acta Universitatis Medicinalis Anhui
2025;60(11):2159-2165
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the risk factors for pulmonary arterial hypertension(PAH) in maintenance peritoneal dialysis(MPD) patients and to develop and validate a nomogram-based risk-prediction model.
Methods:A total of 168 hospitalized MPD patients from the Department of Nephrology were enrolled.Body-fluid composition was measured by bioelectrical impedance analysis,and pulmonary-artery systolic pressure(PASP) was assessed by echocardiography.Patients were randomly allocated into a training set and a validation set at 1:1 ratio.Variables with P< 0. 05 in multivariable Logistic regression in the training set were incorporated to construct a nomogram .The validation set was used to test the model ’s predictive performance . ROC curves , calibration curves , and decision-curve analysis were applied to evaluate accuracy , consistency , and clinical usefulness of the model .
Results:Dialysis vintage ( OR : 1 . 038 , 95% CI: 1 . 008 - 1 . 069 , P = 0. 012) , hemoglobin level ( OR : 0. 961 , 95% CI: 0. 929 - 0. 994 , P = 0. 021) , and extracellular water/intracellular water ratio (E/I) (OR : 1 . 069 , 95% CI: 1 . 024- 1 . 115 , P = 0. 002) were independent risk factors for PAH . ROC analysis yielded area under curve as 0. 867 (95% CI: 0. 782 - 0. 953) and 0. 808 (95% CI: 0. 714 - 0. 902) in the training and validation sets , respectively .Calibration plots showed that the predicted curves for both the training and validation sets closely overlapped with the ideal reference line , indicating that the nomogram risk-prediction model had good predictive performance . Decision-curve analysis demonstrated that , within threshold ranges of 0. 13 - 0. 76 ( training set ) and 0. 20 - 0. 76 (val- idation set ) , clinical net benefit was substantial when interventions were guided by the nomogram .
Conclusion:Dialysis vintage , hemoglobin level , and fluid-overload index (E/I) are independent risk factors for PAH in MPD patients . The nomogram based on these parameters reliably predicts PAH risk and may aid clinical decision-making.
- Full text:2026030522444152832维持性腹膜透析患者并发肺动脉高压危险因素分析及其列线图预测模型的建立与验证_祖爽.pdf
