A study on the correlation of risk factors for type 2 cardiorenal syndrome in patients with chronic heart failure

doi:10.3969/j.issn.1009-0126.2025.08.024

Abstract：Objective To explore the risk factors associated with type 2 cardiorenal syndrome (CRS), and to provide a reference basis for the prevention and treatment of type 2 CRS. Methods A total of 190 patients with chronic heart failure (CHF) who were treated at Jiangsu North People's Hospital from January 2021 to June 2023 were selected. These patients were divided into a type 2 CRS group (n=60) and a non-type 2 CRS group (n=130) based on whether they had type 2 CRS. General clinical data of the two groups were compared. Multivariate logistic regression analysis was used to identify the risk factors for type 2 CRS in CHF patients and to establish a nomogram model. All patients were divided into training and validation sets according to a 7:3 ratio. The model was built in the training set and validated in the validation set. The model's discrimination, calibration, and clinical value were comprehensively evaluated using ROC curves, calibration curves, and decision curves. Results Multivariate logistic regression analysis showed that age (OR=1.039, 95% CI: 1.008–1.074, P=0.017), hypertension (OR=2.567, 95% CI: 1.282–5.268, P=0.009), lipoprotein(a) (OR=1.002, 95% CI: 1.001–1.003, P=0.009), N-terminal B-type natriuretic peptide (OR=1.449, 95% CI: 1.099–1.954, P=0.011), and hemoglobin (OR=0.981, 95% CI: 0.964–0.998, P=0.028) were independent risk factors for type 2 CRS in CHF patients. The area under the curve (AUC) of the combined predictive model was 0.789, with an optimal cutoff value of 0.275, sensitivity of 85.22%, and specificity of 70.03%. The combined predictive model showed better predictive performance than any single variable in the model. The Hosmer-Lemeshow goodness-of-fit test (χ²=12.43, P=0.133) indicated good consistency between the predicted and actual risks of type 2 CRS in CHF patients. Decision curve analysis showed that the nomogram has good clinical practical value. Conclusion Age, hypertension, lipoprotein(a), N-terminal B-type natriuretic peptide, and hemoglobin are independent risk factors for type 2 CRS in CHF patients. The constructed nomogram model shows good predictive performance in predicting type 2 CRS.