Analysis of risk factors and construction of nomogram model for secondary hyperparathyroidism in peritoneal dialysis patients in Qinghai region
Objective To investigate the risk factors of secondary hyperparathyroidism(SHPT) in peritoneal dialysis patients in Qinghai region,and to construct a nomogram model. Method 395 peritoneal dialysis patients admitted to Xining First People's Hospital from January 2021 to March 2023 were selected as the study objects,and they were divided into SHPT group(total parathyroid hormone≥300 ng/L,54 cases) and non-SHPT group(total parathyroid hormone<300 ng/L,341 cases) according to whether they were complicated by SHPT. The clinical data in the two groups were compared and analyzed. Multivariate logistic regression method was used to analyze the independent influencing factors of SHPT in peritoneal dialysis patients. The nomogram model of peritoneal dialysis patients complicated with SHPT was constructed,verified by Bootstrap self-sampling method. And the predictive value of nomogram model on peritoneal dialysis patients complicated with SHPT was analyzed by ROC curve. Result The dialysis age,blood phosphorus,calcium-phosphorus product and ALP in the SHPT group were longer or higher than those in the non-SHPT group,and the differences were statistically significant(P<0.05). Multivariate logistic regression analysis showed that dialysis age,blood phosphorus,calcium-phosphorus product and ALP were independent risk factors for SHPT in peritoneal dialysis patients(P<0.05). According to the results of multivariate logistic regression analysis,R software was used to build a nomogram model for predicting SHPT in peritoneal dialysis patients based on four risk factors,including dialysis age,blood phosphorus,calcium-phosphorus product and ALP. The calibration curve shows that the predicted probability of the nomogram model fits the actual probability well. ROC curve analysis showed that the area under the curve was 0.989(95％CI 0.974-0.998) with sensitivity of 92.69％ and specificity of 98.06％ for predicting SHPT in peritoneal dialysis patients. Conclusion Long dialysis age and increased blood phosphorus,calcium phosphorus product,ALP are independent risk factors for SHPT in peritoneal dialysis patients,the nomogram model built on has a good prediction effect on SHPT in peritoneal dialysis patients.
Peritoneal dialysisSecondary hyperparathyroidismRisk factorsNomogram model
万方数据
维普
