中国现代医学杂志2025，Vol.35Issue(15)：68-74,7.DOI:10.3969/j.issn.1005-8982.2025.15.011
维持性血液透析患者死亡的独立危险因素分析及列线图模型的构建
Analysis of independent risk factors for death in patients on maintenance hemodialysis and construction of a predictive nomogram model
摘要
Abstract
Objective To identify independent risk factors for mortality in patients undergoing maintenance hemodialysis(MHD)and develop a predictive nomogram model.Methods A retrospective analysis included 280 MHD patients treated between April 2019 and April 2024.Patients were categorized into death(n=74)and survival(n=206)groups.Data collected included demographics,comorbidities,dialysis vintage,pre-dialysis laboratory parameters(electrolytes,hemoglobin,albumin,prealbumin,PTH,urea,creatinine,β2-microglobulin,eGFR,CRP,lipids,BNP),and initial dialysis echocardiography(LAD,LCPW,LVDd).Cox proportional hazards regression identified mortality risk factors,and a nomogram was constructed.Results The death group had higher age,chloride,TC,β2-microglobulin,eGFR,CRP,BNP,aortic calcification prevalence,and LAD(P<0.05),and lower phosphate,potassium,iron,transferrin saturation,albumin,LDL-C,creatinine,and urea nitrogen(P<0.05).Multivariate Cox analysis identified high potassium[H^R=0.530(95%CI:0.319,0.880)],high iron[H^R=0.854(95%CI:0.752,0.971)],and high creatinine[H^R=0.994(95%CI:0.991,0.997)]as protective factors,while high eGFR[H^R=1.112(95%CI:1.009,1.226)]and high BNP[H^R=1.004(95%CI:1.001,1.007)]were independent risk factors for death(P<0.05).Conclusion Key factors influencing MHD mortality were identified.The nomogram model effectively predicts survival,aiding clinicians in risk assessment and treatment optimization.关键词
维持性血液透析/死亡危险因素/Cox回归分析/列线图模型/生存曲线Key words
maintenance hemodialysis/mortality risk factors/cox regression analysis/nomogram model/survival curves分类
医药卫生引用本文复制引用
李娜,郑凝,陈绍亮,丁会强..维持性血液透析患者死亡的独立危险因素分析及列线图模型的构建[J].中国现代医学杂志,2025,35(15):68-74,7.基金项目
天津市科技计划项目(No:22KPHDRC00040) （No:22KPHDRC00040）
