Risk of target organ damage in hypertensive patients with unknown hypokalemia evaluated by constructing nomogram based on risk factors

SHEN Jian-hong; YANG Xiang-dong; NIU Wei; SHUANG Lian

doi:10.3969/j.issn.1672-5301.2024.11.016

Abstract：Objective To assess the risk of target organ damage in hypertensive patients with unknown hypokalemia by the nomogram constructed based on the risk factors.Methods The clinical data of 158 patients with hypertension complicated with unexplained hypokalemia hospitalized in the First Hospital of Hohhot City from March 2022 to March 2024 were retrospectively analyzed;according to whether there was target organ damage,the patients were divided into the occurrence group and non-occurrence group.Single factor and multivariate logistic regression analysis were used to identify the risk factors of the target organ damage in hypertensive patients with unexplained hypokalemia;and based on the factors,the nomogram model of target organ damage risk in the patients was constructed.Hosmer-Lemeshow test and receiver operating characteristic curve(ROC)were used to verify the power of the prediction model.Results Acute left heart failure and unstable angina pectoris were the main target organ damage in patients with hypertension and unexplained hypokalemia.The proportion of age ≥60 years old and the levels of homocysteine(Hcy),interleukin-6(IL-6),IL-8 and tumor necrosis factor-α(TNF-α)in the occurrence group were higher than those in the non-occurrence group[59.38％vs.31.75％、(27.52±5.68)μmol/L vs.(19.50±3.52)µmol/L、(48.50±3.78)ng/L vs.(38.95±3.27)ng/L、(30.33±4.92)ng/L vs.(20.02±1.55)ng/L、(59.82±10.15)ng/L vs.(48.55±7.52)ng/L,P＜0.05];IL-10 level was lower than that in the non-occurrence group[(665.25±52.60)ng/L vs.(825.25±74.46)ng/L,P＜0.05].Multivariate logistic regression analysis showed that Age ≥60 years old(OR=1.829,P＜0.05),Hcy(OR=1.874,P＜0.05),IL-6(OR=1.990,P＜0.05),IL-8(OR=1.866,P＜0.05),TNF-α(OR=1.794,P＜0.05)and IL-10(OR=1.874,P＜0.05)were the risk factors for target organ damage in patients with hypertension and unknown hypokalemia.The nomogram model of target organ damage risk in hypertensive patients with unexplained hypokalemia constructed based on the factors showed that the measured values were basically consistent with the predicted values,and the C-index index was 0.889(95％CI 0.728-0.942).Conclusions Age,Hcy,IL-6,IL-8,TNF-α and IL-10 are the risk factors for target organ damage in hypertensive patients with unknown hypokalemia,and the nomogram model constructed based on these factors has good predictive efficacy.