A prediction score model and survival analysis of acute kidney injury following orthotopic liver transplantation in adults

Bao, Banghe; Wang, Wenjing; Wang, Yumei; Chen, Qing

doi:10.21037/apm-21-842

Cited by 4 publications

(2 citation statements)

References 32 publications

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“…In the predictive model for the development of AKI after orthotopic liver transplantation, the analysis showed that the MELD Na score had potential predictive value for patients who developed AKI postoperatively. 38 The model for end-stage liver disease (MELD), with multiple scoring systems derived from it, is currently a widely used liver failure evaluation system in the clinic, and studies have shown that the addition of serum sodium to meld can significantly improve the accuracy of predicting survival, so the MELD Na scoring model was proposed. 85 Furthermore, a study of postoperative AKI prediction in noncardiac surgery showed that gender, EGFR, anemia, hypoalbuminemia, and proteinuria were significantly associated with AKI, but age, diabetes mellitus, expected operation time, emergency surgery, RAAS blocker use, and hyponatremia were not associated with postoperative AKI.…”

Section: Discussionmentioning

confidence: 99%

“…35 Acute kidney injury is associated with metabolic acidosis, volume overload, electrolyte imbalance, and other complications. But we found fewer electrolyte factors to be incorporated in most prediction models, with the highest focus on sodium ions; [36][37][38][39][40][41][42][43][44][45] Some studies have reported potassium ions, [40][41][42]45 but few have investigated the role of chloride ions in the model, only individual studies have explored the case of chloride ions, 44 but the results are still controversial. Therefore, the efficacy of sodium and chloride ions in the serum for predicting the risk of AKI occurrence in the ICU is uncertain.…”

Section: Introductionmentioning

confidence: 99%

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Nomogram Prediction Model of Serum Chloride and Sodium Ions on the Risk of Acute Kidney Injury in Critically Ill Patients

Lu¹,

Qi²,

Liu³

et al. 2022

IDR

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This study aims to investigate the effect of serum chloride and sodium ions on AKI occurrence in ICU patients, and further constructs a prediction model containing these factors to explore the predictive value of these ions in AKI. Methods: The clinical information of patients admitted to ICU of Beijing Friendship Hospital Affiliated to Capital Medical University was collected for retrospective analysis. Logistic regression analysis was used to analyzing the influencing factors. A nomogram for predicting AKI risk was constructed with R software and validated by repeated sampling. Afterwards, the effectiveness and accuracy of the model were tested and evaluated. Results: A total of 446 cases met the requirements of this study, of which 178 developed AKI during their stay in ICU, with an incidence rate of 39.9%. Hypernatremia, heart failure, sepsis, APACHE II score, and initial creatinine value and BE value at ICU admission before the diagnosis of AKI were identified as independent risk factors for developing AKI during ICU stay. These predictors were incorporated into the nomogram of AKI risk in critically ill patients, which was constructed by using R software. Receiver operating characteristic curve analysis was further used and showed that the area under the curve of the model was 0.7934 (95% CI 0.742-0.8447), indicating that the model had an ideal value. Finally, further evaluated its clinical effectiveness. The clinical effect curve and decision curve showed that most areas of the decision curve of this model were greater than 0, indicating that this model owned a certain clinical effectiveness. Conclusion:The nomogram based on hypernatremia, heart failure, sepsis, APACHE II score, and initial creatinine and BE value in ICU can predict the individualized risk of AKI with satisfactory distinguishability and accuracy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nomogram Prediction Model of Serum Chloride and Sodium Ions on the Risk of Acute Kidney Injury in Critically Ill Patients

Lu¹,

Qi²,

Liu³

et al. 2022

IDR

View full text Add to dashboard Cite

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Development and validation of a nomogram for predicting acute kidney injury after orthotopic liver transplantation

et al. 2021

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Background We aim to develop and validate a nomogram model for predicting severe acute kidney injury (AKI) after orthotopic liver transplantation (OLT). Methods A total of 576 patients who received OLT in our center were enrolled. They were assigned to the development and validation cohort according to the time of inclusion. Univariable and multivariable logistic regression using the forward variable selection routine were applied to find risk factors for post-OLT severe AKI. Based on the results of multivariable analysis, a nomogram was developed and validated. Patients were followed up to assess the long-term mortality and development of chronic kidney disease (CKD). Results Overall, 35.9% of patients were diagnosed with severe AKI. Multivariable logistic regression analysis revealed that recipients’ BMI (OR 1.10, 95% CI 1.04–1.17, p = 0.012), hypertension (OR 2.32, 95% CI 1.22–4.45, p = 0.010), preoperative serum creatine (sCr) (OR 0.96, 95% CI 0.95–0.97, p < 0.001), and intraoperative fresh frozen plasm (FFP) transfusion (OR for each 1000 ml increase 1.34, 95% CI 1.03–1.75, p = 0.031) were independent risk factors for post-OLT severe AKI. They were all incorporated into the nomogram. The area under the ROC curve (AUC) was 0.73 ( p < 0.05) and 0.81 ( p < 0.05) in the development and validation cohort. The calibration curve demonstrated the predicted probabilities of severe AKI agreed with the observed probabilities ( p > 0.05). Kaplan-Meier survival analysis showed that patients in the high-risk group stratified by the nomogram suffered significantly poorer long-term survival than the low-risk group (HR 1.92, p < 0.01). The cumulative risk of CKD was higher in the severe AKI group than no severe AKI group after competitive risk analysis (HR 1.48, p < 0.05). Conclusions With excellent predictive abilities, the nomogram may be a simple and reliable tool to identify patients at high risk for severe AKI and poor long-term prognosis after OLT.

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Association Between Different Versions of the Model for End-Stage Liver Disease Score and Contrast-Associated Acute Kidney Injury in Patients Undergoing Elective Percutaneous Coronary Intervention

You

Zhang

et al. 2022

Circ J

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Background: Pre-procedure liver dysfunction was associated with acute kidney injury after percutaneous coronary intervention (PCI). The aim of this study is to assess and compare the predictive value of different liver function scoring systems for contrastassociated acute kidney injury (CA-AKI) in patients undergoing elective PCI. Methods and Results:A total of 5,569 patients were retrospectively enrolled. The model for end-stage liver disease (MELD) including albumin (MELD-Albumin) score (AUC=0.661) had the strongest predictive value in comparison to the MELD score (AUC=0.627), the MELD excluding the international normalized ratio (MELD-XI) score (AUC=0.560), and the MELD including sodium (MELD-Na) score (AUC=0.652). In the fully adjusted logistic regression model, the MELD-Albumin score and the MELD-Na score were independently associated with CA-AKI regardless of whether they were treated as continuous or categorical variables; however, this was not the case for the MELD score and the MELD-XI score. Furthermore, the addition of the MELD-Albumin score significantly improved the reclassification beyond the fully adjusted logistic regression model. The study further explored the association between different versions of the MELD score and CA-AKI using restricted cubic splines and found a linear relationship between the MELD-Albumin score and the risk of CA-AKI. Conclusions:The MELD-Albumin score had the highest predictive value for CA-AKI in patients undergoing elective PCI. The addition of the MELD-Albumin score to the existing risk prediction model significantly improved the reclassification for CA-AKI.

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A prediction score model and survival analysis of acute kidney injury following orthotopic liver transplantation in adults

Cited by 4 publications

References 32 publications

Nomogram Prediction Model of Serum Chloride and Sodium Ions on the Risk of Acute Kidney Injury in Critically Ill Patients

Nomogram Prediction Model of Serum Chloride and Sodium Ions on the Risk of Acute Kidney Injury in Critically Ill Patients

Development and validation of a nomogram for predicting acute kidney injury after orthotopic liver transplantation

Association Between Different Versions of the Model for End-Stage Liver Disease Score and Contrast-Associated Acute Kidney Injury in Patients Undergoing Elective Percutaneous Coronary Intervention

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