| 引用本文:谷梦磊，孙海彤，孙伟，何伟明，许陵冬，张露.基于中医证型的慢性肾脏病患者高钾血症风险预测模型构建和验证[J].世界中医药,2025,(03):. |
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| 基于中医证型的慢性肾脏病患者高钾血症风险预测模型构建和验证 |
| Construction and Validation of a Hyperkalemia Risk Prediction Model for Chronic Kidney Disease Patients Based on Traditional Chinese Medicine Syndrome Types |
| 投稿时间：2024-02-23 |
| DOI：10.3969/j.issn.1673-7202.2025.03.014 |
| 中文关键词: 慢性肾脏病 高钾血症 中医证型 预测模型 列线图 临床研究 非透析 |
| English Keywords:Chronic kidney disease Hyperkalemia Traditional Chinese medicine syndrome types Prediction model Nomogram Clinical study Non-dialysis |
| 基金项目:国家自然科学基金面上项目（82374373）；江苏省“六大人才高峰”高层次人才项目(WSN-021);江苏省中医肾病医学创新中心项目（苏卫科教〔2022〕15号） |
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| 中文摘要: |
| 目的：建立一个基于中医证型的慢性肾脏病（CKD）患者高钾血症风险评估模型。方法：回顾性分析2020年1月至2022年12月在江苏省中医院肾内科门诊就诊的CKD3~5期非透析患者386例作为研究对象，按7∶〖KG-*2〗3的比例分为训练集（270例）和验证集（116例）。采用单因素和多因素logistic回归分析CKD并发高钾血症的影响因素，构建风险评估模型，并用受试者操作特征（ROC）曲线、校准曲线和决策曲线分析（DCA）评价模型的效能。结果：血红蛋白、CKD分期、是否有糖尿病、心力衰竭史、是否服用肾素-血管紧张素-醛固酮系统抑制剂(RAASI)、中医证型是高钾血症的危险因素（P<0.05），根据这些因素建立了一个简单易用的风险评估模型，该模型在训练集和验证集中均表现出良好的区分度（验证集ROC:0.847,95%CI为0.793~0.910;训练集ROC：0.813，95%CI为0.724~0.902）、校准度和临床获益。结论：基于上述6个影响因素构建的列线图能较为准确预测CKD3~5期非透析患者发生高钾血症的风险。 |
| English Summary: |
| To develop a risk assessment model for hyperkalemia in chronic kidney disease(CKD) patients based on traditional Chinese medicine(TCM) syndrome types.Methods:A retrospective study was conducted on 386 non-dialysis CKD stage 3 to 5 patients who visited the Nephrology Department of Jiangsu Province Hospital of Chinese Medicine from January 2020 to December 2022.Patients were randomly divided into a training set(n=270) and a validation set(n=116) in a 7∶〖KG-*2〗3 ratio.Univariate and multivariate logistic regression analyses were performed to identify risk factors for hyperkalemia in CKD patients，and a risk assessment model was constructed.The performance of the model was evaluated using the receiver operating characteristic(ROC) curve，calibration curve，and decision curve analysis(DCA).Results:Hemoglobin levels，CKD stage，presence of diabetes，history of heart failure，use of renin-angiotensin-aldosterone system inhibitors(RAASI)，and TCM syndrome types were identified as significant risk factors for hyperkalemia(P<0.05).A simple and practical risk assessment model was developed based on these factors.The model demonstrated good discrimination in both the training set(ROC：0.813，95%CI 0.724 to 0.902) and the validation set(ROC：0.847，95%CI 0.793 to 0.910)，along with good calibration and clinical benefit.Conclusion:The nomogram based on six key risk factors provides an accurate prediction of hyperkalemia risk in non-dialysis CKD stage 3 to 5 patients，offering a valuable tool for clinical risk stratification and management. |
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