COX Proportional Hazards Regression Model Analysis for Factors Affecting Prognosis of Diabetic Kidney Disease
Objective Based on the COX proportional hazards regression model,the prognostic factors of diabetic kidney dis-ease(DKD)were analyzed to provide a scientific basis for early clinical evaluation and prevention of DKD.Methods It collected the data of DKD patients in multi-center(The First Affiliated Hospital of Henan University of Chinese Medicine,The Third Affil-iated Hospital of Henan University of Chinese Medicine,Henan Provincial Hospital of Traditional Chinese Medicine and Zheng-zhou People's Hospital)from 2010 to 2021,including general data,laboratory indicators,TCM differentiation classification and TCM treatment.Glomerular filtration rate(eGFR)decreased by≥50％,serum creatinine(Scr)doubled,DKD stage 5 and death were used as the outcome indicators,and the time and situation of follow-up outcomes were followed.The COX proportional haz-ards regression model was used to analyze and screen the prognostic factors of DKD.Results In this study,1947 patients were fi-nally included,with a follow-up time of 4.65(4.557-4.746)years,and 305 cases(15.67％)had composite endpoint events.The results of univariate COX regression analysis showed that there were statistically significant differences in the prognosis of DKD patients with different ages,DKD course≥4 years,alcohol history,smoking history,hypertension,coronary heart disease,ce-rebrovascular disease,diabetic foot,diabetic eye disease,glycosylated hemoglobin(HbA1 c),blood uric acid(SUA),Scr,24 h u-rine protein quantification(24 h-UTP),eGFR,heat-dampness and blood stasis syndrome,Qi deficiency of spleen and kidney combined with dampness accumulation and blood stasis syndrome,Yang deficiency of spleen and kidney combined with blood sta-sis syndrome,Chinese medicine fumigation and prognosis of patients taking traditional Chinese medicine(P＜0.05).Multifacto-rial COX regression analysis showed that age[HR(95％CI)=2.52(1.92,3.30)],DKD course[HR(95％CI)=1.62(1.09,2.42)],smoking history[HR(95％CI)=1.61(1.13,2.29)],alcohol history[HR(95％CI)=1.41(1.01,1.95)],cerebro-vascular disease[HR(95％CI)=1.33(1.01,1.75)],diabetic eye disease[HR(95％CI)=1.43(1.13,1.82)],SUA[HR(95％CI)=1.72(1.26,2.33)],24 h-UTP[HR(95％CI)=1.48(1.14,1.91)],Qi deficiency of spleen and kidney com-bined with dampness accumulation and blood stasis syndrome[HR(95％CI)=2.22(1.44,3.43)]closely associated with the risk of an endpoint event in DKD(P＜0.05).Taking traditional Chinese medicine[HR(95％CI)=2.57(2.00,3.31)]reduced the occurrence of endpoint events(P＜0.05).Conclusions Age,DKD course,smoking history,alcohol history,cerebrovascular disease,diabetic eye disease,SUA,24 h-UTP,Qi deficiency of spleen and kidney combined with dampness accumulation and blood stasis syndrome are the risk factors affecting the prognosis of DKD patients,and taking traditional Chinese medicine treat-ment is its protective factor.
diabetic kidney diseaseprognosisinfluencing factorsCOX proportional hazards regression model
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