ICU急性肾损伤病人进展至3期的早期预测模型构建

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[关键词]急性肾损伤；重症监护病房；疾病恶化；预测；列线图[中图分类号］R692.5 [文献标志码]A [文章编号] 2096-5532（2025）03-0449-05doi：10.11712/jms.2096-5532.2025.61.101 [开放科学（资源服务）标识码（OSID）][网络出版] https：//link.cnki.net/urlid/37.1517.R.20250730.1031.004; 2025-07-3014：46：54

Establishmentofanearlypredictivemodelforprogresiontostage3inpatientswithacutekidneyinjuryintheintensivecarenit CHEN Beixiang，HUANG Zhiwen，LIULele（Departmentof IntensiveCare Medicine，Fifth Afiliated Hospitalof Zhengzhou University，Zhengzhou 45000o，China）

[Abstract]ObjectiveTo investigate the influencing factors for progressionto stage 3acute kidney injury（AKI in patients admitedtotheintensivecareunit（ICU），andtoestablishanomogrampredictionmodel.MethodsAtotalof169AKIpatients who were admitted to the ICU in our hospital fromJanuary 2022 to January 2024 were enroled，andat a ratio of 3：1 ，theywere randomly dividedintoatrainingset with128patientsandavalidationset with41 patients.Accordingtothe presenceorbsenceof progression to stage 3 AKI，they were divided into stage 1-2 AKI group and stage 3 AKI group. The influencing factors for progresion to stage3AKI were analyzed，andanomogram prediction model was established.ResultsThere were significant differences between the stage 1-2 AKI group and the stage 3 AKI group in comorbidity with type 2 diabetes，preoperative renal function staging，white bloodcell（WBC）count，historyofprotonpump inhibitor（PPIuse，andurinaryproteincharacterization （20 （χ2=6.171-15.197，P<0.05） . The multivariate logistic regression showed that preoperative renal function staging，WBC count， history of PPI use，and urinary protein characterization were risk factors for progresson to stage 3 AKI （ P<0.05） .Thenomogram prediction model for progresson to stage 3 AKI had an area under the ROC curve of . The calibrationcurveandtheclinical decisioncurve showed that thenomogram modelhad goodpredictive performance.ConclusionPreo perativerenalfunctionstaging，WBCcount，historyofIuse，andurinaryproteincharacterizationareriskfactorsforprogresion to stage3AKI.Thenomogram predictionmodelforprogressiontostage3AKIestablishedbasedontheaboveriskfactors hasgood predictive performance.

[Key words]acute kidney injury；intensive care unit；disease progression；forecasting； nomograms

急性肾损伤（AKD是由多种病因引起的短时间内肾功能快速减退的临床综合征，特征为肾小球滤过率显著下降，导致体内氮质产物潴留，同时伴随水电解质和酸碱平衡的紊乱[1]。（剩余5841字）