Analysis of risk factors for acute kidney injury in patients with sepsis and construction of a Nomogram predictive model

AO Xue; DENG Chao; HOU Yu; WU Sheng-zan

doi:10.13820/j.cnki.gdyx.20230443

Abstract：Objective To analyze the risk factors for acute kidney injury(AKI)in patients with sepsis and con-struct a Nomogram predictive model.Methods A total of 180 patients with sepsis from March 2020 to September 2022 were selected as the research subjects and divided into an AKI group(n=75)and a non-AKI group(n=105)based on the presence of AKI.The predictive value of continuous variables was analyzed by ROC experiments,and logistic regres-sion was used to analyze the risk factors for AKI in patients with sepsis.The clinical efficacy of the Nomogram model was validated using internal data.Results There were no statistically significant differences in general data between the two groups(P＞0.05).Compared with the non-AKI group,the AKI group had a higher proportion of males,more cases of pulmonary infection,lower mean arterial pressure(MAP),higher levels of lactate,white blood cell count,and multiple organ dysfunction syndrome(MODS)score(P＜0.05).The AUC values for MAP,lactate,procalcitonin,white blood cell count,and MODS score were 0.823,0.921,0.663,0.948,and 0.946,respectively.Male gender,pulmonary in-fection,MAP(≤89 mmHg),lactate(＞2.13 mmol/L),white blood cell count(＞15 × 109·L-1),and MODS score(＞6 points)were all risk factors for AKI in patients with sepsis(P＜0.05).The C-index for predicting the risk of AKI in patients with sepsis using the Nomogram model was 0.763(95％CI:0.651-0.832).Conclusion Male gender,pulmonary infection,low MAP,high lactate,elevated white blood cell count,and increased MODS score are risk factors for AKI in patients with sepsis.The nomogram model constructed based on these variables can effectively predict the oc-currence of AKI in patients with sepsis.