A NOMOGRAM FOR PREDICTING THE RISK OF ACUTE KIDNEY INJURY FOR PATIENTS WITH SEVERE COMMUNITY-ACQUIRED PNEUMONIA

Abstract

Objective: The objective of this study was to determine the characteristics that increase the likelihood of acute kidney injury (AKI) in patients with severe community-acquired pneumonia (SCAP) and to create a predictive nomogram for AKI. Methods: This study comprised individuals who received a diagnosis of SCAP over the period from January 01, 2019, to December 31, 2023. The patients were categorized into two groups: AKI and non-AKI. The clinical and demographic characteristics of the patients were extracted from their medical records. An analysis was conducted to compare the rates of survival at 30 and 90 days among various groups. A multivariate analysis was performed to discover the autonomous risk factors linked to SCAP. The nomogram was built based on these parameters. A receiver operating characteristics (ROC) curve study was performed to assess the predictive accuracy of the nomogram, namely by measuring the area under the curve (AUC). Results: Initial screening was conducted on a total of 1218 patients. After excluding 744 individuals who did not meet the exclusion criteria, a total of 474 patients, with an average age of [Formula: see text] years and a female representation of 33.3%, were selected for inclusion in this study. The prevalence of AKI in the subjects with SCAP was 47.7%. Out of these instances, 39.8% were categorized as AKI stage 1, 31.0% as AKI stage 2, and 29.2% as AKI stage 3. Those diagnosed with AKI exhibited a significantly higher mortality rate at both the 30-day and 90-day marks in comparison to those who did not have AKI. The independent risk factors for AKI were determined to include age, male gender, chronic renal disease, diabetes, and the utilization of nonsteroidal anti-inflammatory medicines (NSAIDs). In addition, higher levels of baseline serum creatinine and uric acid were identified as risk factors for AKI. The final predictive nomogram achieved an AUC of 0.811, with a 95% confidence interval (CI) ranging from 0.773 to 0.849. Conclusion: Our nomogram can serve as a valuable tool for evaluating the progression of AKI in patients with SCAP.