School of Nursing, Chengdu Medical College, Chengdu, China.
Health Management Center, Sichuan Tai Kang Hospital, Chengdu, China.
Ren Fail. 2024 Dec;46(1):2317450. doi: 10.1080/0886022X.2024.2317450. Epub 2024 Feb 29.
The high prevalence of mild cognitive impairment (MCI) in non-dialysis individuals with chronic kidney disease (CKD) impacts their prognosis and quality of life.
This study aims to investigate the variables associated with MCI in non-dialysis outpatient patients with CKD and to construct and verify a nomogram prediction model.
416 participants selected from two hospitals in Chengdu, between January 2023 and June 2023. They were categorized into two groups: the MCI group ( = 210) and the non-MCI ( = 206). Univariate and multivariate binary logistic regression analyses were employed to identify independent influences (candidate predictor variables). Subsequently, regression models was constructed, and a nomogram was drawn. The restricted cubic spline diagram was drawn to further analyze the relationship between the continuous numerical variables and MCI. Internally validated using a bootstrap resampling procedure.
Among 416 patients, 210 (50.9%) had MCI. Logistic regression analysis revealed that age, educational level, occupational status, use of smartphones, sleep disorder, and hemoglobin were independent influencing factors of MCI (all <.05). The model's area under the curve was 0.926,95% (0.902, 0.951), which was a good discriminatory measure; the Calibration curve, the Hosmer-Lemeshow test, and the Clinical Decision Curve suggested that the model had good calibration and clinical benefit. Internal validation results showed the consistency index was 0.926, 95% (0.925, 0.927).
The nomogram prediction model demonstrates good performance and can be used for early screening and prediction of MCI in non-dialysis patients with CKD. It provides valuable reference for medical staff to formulate corresponding intervention strategies.
非透析慢性肾脏病(CKD)患者中轻度认知障碍(MCI)的高患病率影响其预后和生活质量。
本研究旨在探讨非透析门诊CKD 患者 MCI 的相关变量,并构建和验证列线图预测模型。
本研究选取 2023 年 1 月至 6 月在成都两家医院的 416 名参与者,将其分为 MCI 组( = 210)和非 MCI 组( = 206)。采用单因素和多因素二分类 Logistic 回归分析确定独立影响因素(候选预测变量)。然后,构建回归模型并绘制列线图。绘制受限立方样条图进一步分析连续数值变量与 MCI 的关系。通过自举重采样程序进行内部验证。
在 416 名患者中,210 名(50.9%)患有 MCI。Logistic 回归分析显示,年龄、受教育程度、职业状况、使用智能手机、睡眠障碍和血红蛋白是 MCI 的独立影响因素(均 <.05)。模型的曲线下面积为 0.926,95%(0.902,0.951),具有良好的区分度;校准曲线、Hosmer-Lemeshow 检验和临床决策曲线表明该模型具有良好的校准度和临床获益。内部验证结果显示,一致性指数为 0.926,95%(0.925,0.927)。
该列线图预测模型具有良好的性能,可用于非透析 CKD 患者 MCI 的早期筛查和预测,为医务人员制定相应的干预策略提供了有价值的参考。