DataSheet_1_Development and Validation of a Prediction Model for Survival in Diabetic Patients With Acute Kidney Injury.pdf

ObjectiveWe aimed to analyze the risk factors affecting all-cause mortality in diabetic patients with acute kidney injury (AKI) and to develop and validate a nomogram for predicting the 90-day survival rate of patients.MethodsClinical data of diabetic patients with AKI who were diagnosed at The First Affiliated Hospital of Guangxi Medical University from April 30, 2011, to April 30, 2021, were collected. A total of 1,042 patients were randomly divided into a development cohort and a validation cohort at a ratio of 7:3. The primary study endpoint was all-cause death within 90 days of AKI diagnosis. Clinical parameters and demographic characteristics were analyzed using Cox regression to develop a prediction model for survival in diabetic patients with AKI, and a nomogram was then constructed. The concordance index (C-index), receiver operating characteristic curve, and calibration plot were used to evaluate the prediction model.ResultsThe development cohort enrolled 730 patients with a median follow-up time of 87 (40–98) days, and 86 patients (11.8%) died during follow-up. The 90-day survival rate was 88.2% (644/730), and the recovery rate for renal function in survivors was 32.9% (212/644). Multivariate analysis showed that advanced age (HR = 1.064, 95% CI = 1.043–1.085), lower pulse pressure (HR = 0.964, 95% CI = 0.951–0.977), stage 3 AKI (HR = 4.803, 95% CI = 1.678–13.750), lower 25-hydroxyvitamin D3 (HR = 0.944, 95% CI = 0.930–0.960), and multiple organ dysfunction syndrome (HR = 2.056, 95% CI = 1.287–3.286) were independent risk factors affecting the all-cause death of diabetic patients with AKI (all p

本研究旨在分析影响糖尿病急性肾损伤（AKI）患者全因死亡率的危险因素，并开发及验证一套预测患者90天生存率的诺谟图。研究方法包括收集广西医科大学第一附属医院于2011年4月30日至2021年4月30日期间诊断的糖尿病AKI患者的临床数据。共计1,042名患者按7:3的比例随机分为开发组和验证组。主要研究终点为AKI诊断后90天内发生全因死亡。通过Cox回归分析临床参数和人口统计学特征，构建预测糖尿病AKI患者生存率的预测模型，随后构建诺谟图。使用一致性指数（C-index）、受试者工作特征曲线和校准图来评估预测模型的性能。研究结果揭示，开发组纳入730例患者，中位随访时间为87（40–98）天，其中86例患者（11.8%）在随访期间死亡。90天生存率为88.2%（644/730），生存者肾功能恢复率为32.9%（212/644）。多因素分析显示，高龄（HR = 1.064，95% CI = 1.043–1.085）、脉压降低（HR = 0.964，95% CI = 0.951–0.977）、AKI 3期（HR = 4.803，95% CI = 1.678–13.750）、25-羟基维生素D3水平降低（HR = 0.944，95% CI = 0.930–0.960）以及多器官功能障碍综合征（HR = 2.056，95% CI = 1.287–3.286）是影响糖尿病AKI患者全因死亡的独立危险因素（所有p值均小于0.05）。