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ORIGINAL RESEARCH article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1563425
Nomogram risk prediction model for acute respiratory distress syndrome following acute kidney injury
Provisionally accepted- 1 Second Hospital of Shanxi Medical University, Taiyuan, China
- 2 Department of Endocrinology, Air force Medical Center, Beijing, China
Background: Acute respiratory distress syndrome (ARDS), a severe form of respiratory failure, can be precipitated by acute kidney injury (AKI), leading to a significant increase in mortality among affected patients. This study aimed to identify the risk factors for ARDS and construct a predictive nomogram.Methods: We conducted a retrospective analysis of 1241 AKI patients admitted to the Second Hospital of Shanxi Medical University from August 25, 2016, to December 31, 2023. The patients were divided into a study cohort (1012 cases, including 108 with ARDS) and a validation cohort (229 cases, including 23 with ARDS). Logistic regression analysis was employed to identify the risk factors for ARDS, which were subsequently incorporated into the development of a nomogram. The predictive performance of the nomogram was assessed by AUC, calibration plots, and decision curve analyses, with external validation also performed.Results: Six risk factors were identified and included in the nomogram: older age (OR=1.020; 95%CI=1.005-1.036), smoking history (OR=1.416; 95%CI=1.213-1.811), history of diabetes mellitus (OR=1.449; 95%CI=1.202-1.797), mean arterial pressure (MAP; OR=1.165; 95%CI=1.132-1.199), higher serum uric acid levels (OR=1.002; 95%CI=1.001-1.004), and higher AKI stage [(stage 1: reference), (stage 2: OR=11.863; 95%CI=4.850-29.014), (stage 3: OR=41.398; 95%CI=30.840-52.731)]. The AUC values were 0.951 in the study cohort and 0.959 in the validation cohort. Calibration and decision curve analyses confirmed the accuracy and clinical utility of the nomogram. Conclusions: The nomogram, which integrates age, smoking history, diabetes mellitus history, MAP, and AKI stage, predicts the risk of ARDS in patients with AKI. This tool may aid in early detection and facilitate clinical decision-making.Introduction
Keywords: Acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), risk factor, Early prediction, nomogram
Received: 20 Jan 2025; Accepted: 28 Mar 2025.
Copyright: © 2025 Lin, Ren, Cui, Guo, Wang, Wang, Su and Qiao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xi Qiao, Second Hospital of Shanxi Medical University, Taiyuan, China
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