Risk factors and early prediction of cardiorenal syndrome type 3 among acute kidney injury patients: a cohort study

Area of Science:

• Nephrology
• Cardiology
• Internal Medicine

Background:

• Cardiorenal syndrome type 3 (CRS type 3) involves acute cardiac injury secondary to acute kidney injury (AKI), significantly increasing mortality in AKI patients.
• Identifying predictors for CRS type 3 is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To identify risk factors associated with CRS type 3 in patients with AKI.
• To develop and validate a predictive nomogram for CRS type 3 in AKI patients.

Main Methods:

• A retrospective study involving 805 AKI patients, divided into a study cohort (2017-2021) and a validation cohort (2021).
• Logistic regression analysis was used to identify risk factors for CRS type 3.
• A predictive nomogram was constructed and its performance evaluated using AUC, calibration curves, and decision curve analysis.

Main Results:

• Six significant risk factors for CRS type 3 were identified: age, history of cardiovascular disease (CVD), mean artery pressure (MAP), hemoglobin levels, homocysteine levels, and AKI stage.
• The predictive nomogram demonstrated excellent performance with an Area Under the Curve (AUC) of 0.907 in the study cohort and 0.892 in the validation cohort.
• The nomogram's accuracy and clinical utility were confirmed through calibration and decision curve analyses.

Conclusions:

• A validated nomogram incorporating age, CVD history, MAP, hemoglobin, homocysteine, and AKI stage effectively predicts CRS type 3 in AKI patients.
• This tool enhances early risk stratification and facilitates personalized patient management strategies for CRS type 3.