To construct a predictive risk model of early kidney injury in preeclampsia
Objective Based on the risk factors,the prediction risk model of early preeclampsia kidney injury was constructed and its prediction efficiency was evaluated.Methods 96 cases of preeclampsia patients admitted to the Fourth Affiliated Hospital of Nanjing Medical University from January 2021 to November 2023 were selected as the research objects,and were divided into kidney injury group and no kidney injury group according to the occurrence of early kidney injury,the clinical data of the two groups were compared,and the risk factors affecting early kidney injury of preeclampsia were identified by Logistic multivariate regression analysis. R software was used to construct a risk nomogram model of early preeclampsia kidney injury based on the risk factors affecting early preeclampsia kidney injury. Goodness of fit and receiver operating characteristic curve ( ROC) were used to evaluate the predictive efficiency of the model. Results The incidence of early kidney injury in preeclampsia patients was about 43.75％(42/96). There were statistically significant differences in the proportions of hyperglycemia,hypertension,severe preeclampsia and the levels of uric acid,homocysteine and cystatin C between the two groups (P<0.05),while there were no statistically significant differences in age,gestational age,body weight,fatty liver ratio and placenta previa ratio ( P>0.05 ) . Logistic multivariate regression analysis showed:hyperglycemia (OR=1.842,95％CI:1.627-2.152),hypertension (OR=1.798,95％CI:1.696-2.054),severe preeclampsia (OR=1. 854,95％CI:1.683-2.325),high uric acid level (OR=1.825,95％CI:1.622-2.278),high homocysteine level (OR=1.825,95％CI:1.624-2.357),high cystatin C level (OR=1.818,95％CI:1.658-2.274) were risk factors for kidney injury in early preeclampsia. The C-index of the risk profile model of early preeclampsia kidney injury constructed based on the above risks was 0.899 (95％CI:0.812-0.935),which confirmed that the model had good predictive efficacy.Conclusion Hyperglycemia,hypertension,severe preeclampsia,uric acid,homocysteine,cystatin C are risk factors for early preeclampsia kidney injury,and the nomogram model based on this construction is effective in predicting early preeclampsia kidney injury.
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