NDLI: Nomogram to predict the risk of acute kidney injury in patients with diabetic ketoacidosis: an analysis of the MIMIC-III database

Content Provider	Springer Nature : BioMed Central
Author	Fan, Tingting Wang, Haosheng Wang, Jiaxin Wang, Wenrui Guan, Haifei Zhang, Chuan
Abstract	Background This study aimed to develop and validate a nomogram for predicting acute kidney injury (AKI) during the Intensive Care Unit (ICU) stay of patients with diabetic ketoacidosis (DKA). Methods A total of 760 patients diagnosed with DKA from the Medical Information Mart for Intensive Care III (MIMIC-III) database were included and randomly divided into a training set (70%, n = 532) and a validation set (30%, n = 228). Clinical characteristics of the data set were utilized to establish a nomogram for the prediction of AKI during ICU stay. The least absolute shrinkage and selection operator (LASSO) regression was utilized to identified candidate predictors. Meanwhile, a multivariate logistic regression analysis was performed based on variables derived from LASSO regression, in which variables with P < 0.1 were included in the final model. Then, a nomogram was constructed applying these significant risk predictors based on a multivariate logistic regression model. The discriminatory ability of the model was determined by illustrating a receiver operating curve (ROC) and calculating the area under the curve (AUC). Moreover, the calibration plot and Hosmer-Lemeshow goodness-of-fit test (HL test) were conducted to evaluate the performance of our newly bullied nomogram. Decision curve analysis (DCA) was performed to evaluate the clinical net benefit. Results A multivariable model that included type 2 diabetes mellitus (T2DM), microangiopathy, history of congestive heart failure (CHF), history of hypertension, diastolic blood pressure (DBP), urine output, Glasgow coma scale (GCS), and respiratory rate (RR) was represented as the nomogram. The predictive model demonstrated satisfied discrimination with an AUC of 0.747 (95% CI, 0.706–0.789) in the training dataset, and 0.712 (95% CI, 0.642–0.782) in the validation set. The nomogram showed well-calibrated according to the calibration plot and HL test (P > 0.05). DCA showed that our model was clinically useful. Conclusion The nomogram predicted model for predicting AKI in patients with DKA was constructed. This predicted model can help clinical physicians to identify the patients with high risk earlier and prevent the occurrence of AKI and intervene timely to improve prognosis.
Related Links	https://bmcendocrdisord.biomedcentral.com/counter/pdf/10.1186/s12902-021-00696-8.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	14726823
DOI	10.1186/s12902-021-00696-8
Journal	BMC Endocrine Disorders
Issue Number	1
Volume Number	21
Language	English
Publisher	BioMed Central
Publisher Date	2021-03-04
Access Restriction	Open
Subject Keyword	Endocrinology Metabolic Diseases Diabetes Andrology Diabetes mellitus Diabetic ketoacidosis Acute kidney injury Nomogram
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3.1/2023

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