Risk factors and nomogram prediction model for hypocalcemia in patients undergoing hemodialysis

Area of Science:

• Nephrology
• Endocrinology
• Clinical Chemistry

Background:

• Hypocalcemia is a common complication in hemodialysis patients, linked to mineral metabolism disturbances, cardiovascular risks, and bone issues.
• Early identification of high-risk individuals is crucial for effective prevention and management.
• This study aimed to identify risk factors and create a predictive model for hypocalcemia.

Purpose of the Study:

• To evaluate risk factors associated with hypocalcemia in maintenance hemodialysis patients.
• To develop and validate a nomogram prediction model for individualized hypocalcemia risk assessment.

Main Methods:

• A retrospective study of 386 hemodialysis patients (2020-2024).
• Hypocalcemia defined as serum calcium < 2.1 mmol/L.
• Logistic regression identified predictors; a nomogram was constructed and validated using ROC curves, calibration plots, and DCA.

Main Results:

• Independent risk factors for hypocalcemia included thyroid disease, elevated serum creatinine, and hyperphosphatemia.
• Protective factors were higher parathyroid hormone (PTH) levels and compound α-ketoacid use.
• The nomogram showed good discrimination (AUC=0.846) and calibration, with favorable clinical utility.

Conclusions:

• The developed nomogram is a reliable tool for predicting hypocalcemia in hemodialysis patients.
• It facilitates improved risk stratification and personalized management strategies.
• The model aids clinicians in proactive intervention for at-risk individuals.