Construction and validation of a predictive model for the risk of peritoneal dialysis-associated peritonitis after peritoneal dialysis catheterization
AimTo construct and validate a risk prediction model for the development of peritoneal dialysis-associated peritonitis (PDAP) in patients undergoing peritoneal dialysis (PD).MethodsThis retrospective analysis included patients undergoing PD at the Department of Nephrology, the First Affiliated Hospi...
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1193754/full |
| _version_ | 1827817637778817024 |
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| author | Rong Dai Chuyi Peng Tian Sang Meng Cheng Yiping Wang Lei Zhang |
| author_facet | Rong Dai Chuyi Peng Tian Sang Meng Cheng Yiping Wang Lei Zhang |
| author_sort | Rong Dai |
| collection | DOAJ |
| description | AimTo construct and validate a risk prediction model for the development of peritoneal dialysis-associated peritonitis (PDAP) in patients undergoing peritoneal dialysis (PD).MethodsThis retrospective analysis included patients undergoing PD at the Department of Nephrology, the First Affiliated Hospital of Anhui University of Chinese Medicine, between January 2016 and January 2021. Baseline data were collected. The primary study endpoint was PDAP occurrence. Patients were divided into a training cohort (n = 264) and a validation cohort (n = 112) for model building and validation. Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to optimize the screening variables. Predictive models were developed using multifactorial logistic regression analysis with column line plots. Receiver operating characteristic (ROC) curves, calibration curves, and Hosmer-Lemeshow goodness-of-fit tests were used to verify and evaluate the discrimination and calibration of the prediction models. Decision curve analysis (DCA) was used to assess the clinical validity of the prediction models.ResultsFive potential predictors of PDAP after PD catheterization were screened using LASSO regression analysis, including neutrophil-to-lymphocyte ratio (NLR), serum ALBumin (ALB), uric acid (UA), high sensitivity C-reactive protein (hsCRP), and diabetes mellitus (DM). Predictive models were developed by multi-factor logistic regression analysis and plotted in columns. The area under the ROC curve (AUC) values were 0.891 (95% confidence interval [CI]: 0.829–0.844) and 0.882 (95% CI: 0.722–0.957) for the training and validation cohorts, respectively. The Hosmer-Lemeshow test showed a good fit (p = 0.829 for the training cohort; p = 0.602 for the validation cohort). The DCA curves indicated that the threshold probabilities for the training and validation cohorts were 4–64% and 3–90%, respectively, predicting a good net gain for the clinical model.ConclusionNLR, ALB, UA, hsCRP, and DM are independent predictors of PDAP after PD catheterization. The column line graph model constructed based on the abovementioned factors has good discriminatory and calibrating ability and helps to predict the risk of PDAP after PD catheterization. |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-12T00:37:04Z |
| publishDate | 2023-09-01 |
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| spelling | doaj.art-56a1a360350e49d7b893676d6ef2da472023-09-15T09:27:58ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-09-011010.3389/fmed.2023.11937541193754Construction and validation of a predictive model for the risk of peritoneal dialysis-associated peritonitis after peritoneal dialysis catheterizationRong Dai0Chuyi Peng1Tian Sang2Meng Cheng3Yiping Wang4Lei Zhang5Department of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, ChinaGraduate School, Anhui University of Chinese Medicine, Hefei, ChinaGraduate School, Anhui University of Chinese Medicine, Hefei, ChinaDepartment of Nephrology, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, ChinaDepartment of Nephrology, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, ChinaDepartment of Nephrology, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, ChinaAimTo construct and validate a risk prediction model for the development of peritoneal dialysis-associated peritonitis (PDAP) in patients undergoing peritoneal dialysis (PD).MethodsThis retrospective analysis included patients undergoing PD at the Department of Nephrology, the First Affiliated Hospital of Anhui University of Chinese Medicine, between January 2016 and January 2021. Baseline data were collected. The primary study endpoint was PDAP occurrence. Patients were divided into a training cohort (n = 264) and a validation cohort (n = 112) for model building and validation. Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to optimize the screening variables. Predictive models were developed using multifactorial logistic regression analysis with column line plots. Receiver operating characteristic (ROC) curves, calibration curves, and Hosmer-Lemeshow goodness-of-fit tests were used to verify and evaluate the discrimination and calibration of the prediction models. Decision curve analysis (DCA) was used to assess the clinical validity of the prediction models.ResultsFive potential predictors of PDAP after PD catheterization were screened using LASSO regression analysis, including neutrophil-to-lymphocyte ratio (NLR), serum ALBumin (ALB), uric acid (UA), high sensitivity C-reactive protein (hsCRP), and diabetes mellitus (DM). Predictive models were developed by multi-factor logistic regression analysis and plotted in columns. The area under the ROC curve (AUC) values were 0.891 (95% confidence interval [CI]: 0.829–0.844) and 0.882 (95% CI: 0.722–0.957) for the training and validation cohorts, respectively. The Hosmer-Lemeshow test showed a good fit (p = 0.829 for the training cohort; p = 0.602 for the validation cohort). The DCA curves indicated that the threshold probabilities for the training and validation cohorts were 4–64% and 3–90%, respectively, predicting a good net gain for the clinical model.ConclusionNLR, ALB, UA, hsCRP, and DM are independent predictors of PDAP after PD catheterization. The column line graph model constructed based on the abovementioned factors has good discriminatory and calibrating ability and helps to predict the risk of PDAP after PD catheterization.https://www.frontiersin.org/articles/10.3389/fmed.2023.1193754/fullperitoneal dialysisperitoneal dialysis-associated peritonitisperitoneal dialysis catheterizationnomogrampredictive model |
| spellingShingle | Rong Dai Chuyi Peng Tian Sang Meng Cheng Yiping Wang Lei Zhang Construction and validation of a predictive model for the risk of peritoneal dialysis-associated peritonitis after peritoneal dialysis catheterization Frontiers in Medicine peritoneal dialysis peritoneal dialysis-associated peritonitis peritoneal dialysis catheterization nomogram predictive model |
| title | Construction and validation of a predictive model for the risk of peritoneal dialysis-associated peritonitis after peritoneal dialysis catheterization |
| title_full | Construction and validation of a predictive model for the risk of peritoneal dialysis-associated peritonitis after peritoneal dialysis catheterization |
| title_fullStr | Construction and validation of a predictive model for the risk of peritoneal dialysis-associated peritonitis after peritoneal dialysis catheterization |
| title_full_unstemmed | Construction and validation of a predictive model for the risk of peritoneal dialysis-associated peritonitis after peritoneal dialysis catheterization |
| title_short | Construction and validation of a predictive model for the risk of peritoneal dialysis-associated peritonitis after peritoneal dialysis catheterization |
| title_sort | construction and validation of a predictive model for the risk of peritoneal dialysis associated peritonitis after peritoneal dialysis catheterization |
| topic | peritoneal dialysis peritoneal dialysis-associated peritonitis peritoneal dialysis catheterization nomogram predictive model |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1193754/full |
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