Establishment and analysis of the nomogram model of lean tissue decline in Stage 4-5 patients with chronic kidney disease without dialysis / 肠外与肠内营养

ABSTRACT

Objective:To establish a nomogram prediction model for lean tissue decline in non-dialysis patients with Stage 4-5 chronic kidney disease(CKD),in order to provide reference for early clinical identification and screening of related risk factors.Methods:A total of 247 patients with CKD stage 4-5 who were treated in Wuhan Fifth Hospital from July 2018 to December 2021 were selected and divided into normal LTI group and low LTI group according to lean body tissue index(LTI).Clinical data were collected.Logistic regression were used to analyze the risk factors of lean tissue decline.A nomogram prediction model was constructed by R software package(R3.5.3),and calibration curve and ROC curve were drawn to evaluate the model differentiation and accuracy.Results:Among 247 CKD stage 4-5 patients,148 cases(59.92％)were in normal LTI group and 99 cases(40.08％)were in low LTI group.Logistic regression analysis showed age(OR=1.441,P=0.012),diabetic kidney disease(OR=2.153,P=0.029),body mass index(OR=1.639,P=0.023),calf circumference(OR=3.247,P=0.011)and carbon dioxide(OR=3.573,P=0.004)entered the regression equation.Based on the above five risk factors,a nomogram prediction model was established and verified.The correction curve all approached the ideal curve,and the slope of the calibration curve was close to 1(x2=3.549,P=0.637).The AUC of ROC curve was 0.792(95％CI:0.714～0.897).Conclusions:The nomogram based on age,diabetic kidney disease,body mass index,calf circumference and carbon dioxide showed good differentiation and accuracy in predicting lean tissue decline in CKD stage 4-5 non-dialysis patients.