Influence factor analysis of mild cognitive impairment in maintenance peritoneal dialysis patients and construction of prediction model
Wang Jiali
Chang Hongjuan
Lyu Yumin
Yang Guoling
Li Qing
Tian Juanjuan
Wang Lina
Abstract：Objective To analyze the risk factors for mild cognitive impairment(MCI)in maintenance peritoneal dialysis(MPD)patients,and construct a prediction model.Methods A total of 120 patients who underwent MPD at the First Affil-iated Hospital of Xinxiang Medical University from January 2021 to January 2024 were selected.They were divided into nor-mal cognitive function group(n=55)and MCI group(n=65)based on cognitive function screening results.General infor-mation and laboratory indicators of the two groups were compared.Multivariate logistic regression analysis was conducted to identify the factors influencing MCI in MPD patients.A prediction model was constructed based on the influencing factors,and the ROC curve was used to evaluate predictive performance of this prediction model.Results The proportion of age≥60 years old,the proportion of education of junior high school or below,the age of dialysis,the history of diabetes and the level of homocysteine(Hcy)in MCI group were higher than those in normal cognitive function group,and the levels of pre-albumin(PAB)and parathyroid hormone(iPTH)in MCI group were lower than those in normal cognitive function group(P<0.05).Multivariate logistic regression analysis showed that age(OR=1.322,95%CI:1.080-1.617),education level(OR=1.369,95%CI:1.099-1.705),dialysis age(OR=1.399,95%CI:1.135-1.726),PAB(OR=1.505,95%CI:1.185-1.912),Hcy(OR=1.527,95%CI:1.214-1.920),and iPTH(OR=1.516,95%CI:1.180-1.948)were independent risk factors for MCI in MPD patients(P<0.05).Based on above factors,a prediction model was constructed and the expression was Logit P=-7.566+0.279×age+0.314×education level+0.336×dialysis age+0.409×PAB+0.423×Hcy+0.416×iPTH.Hosmer-Lemeshow test showed that this model had high fitness of good(P=0.604).The area under the ROC curve(AUC),sensitivity and specificity of the prediction model were 0.939,90.77%and 89.09%(95%CI:0.796-0.907).Conclusion Age,educational level,dialysis age,PAB,Hcy and iPTH levels are closely related to the occurrence of MCI in MPD patients.The prediction model constructed based on influencing factors has good predictive performance and can provide reference for clinical practice.
Keywords：Maintenance peritoneal dialysisMild cognitive impairmentlogistic regression analysisPrediction model
Publication Date：2024-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 70-76 )