Predictive value of EASIX for CKD patients with CRS

This study aimed to investigate predictive value of endothelial activation and the endothelial activation and stress index (EASIX) for chronic kidney disease (CKD) patients with cardiorenal syndrome (CRS). A retrospective study was conducted on 253 CKD patients admitted to our hospital from January 2021 to June 2024. Patients were divided into CRS group (n = 77) and non-CRS group (n = 176). Univariate and binary Logistics regression analyses were performed to identify influencing factors. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of EASIX for CKD patients with CRS. There were significant differences in terms of hypertension, red blood cell count, red cell distribution width (RDW), blood urea nitrogen, albumin, interleukin-6, C-reactive protein, EASIX, and CKD stage between the 2 groups (P < .05). Binary Logistics regression analysis indicated that RDW, EASIX, and CKD stagings were independent influencing factors for CKD patients with CRS (P < .05). The predictive area under the curve (AUC) for EASIX was 0.821 with a standard error of 0.028 (95% confidence interval [CI]: 0.767-0.876), with a Youden index of 0.62, sensitivity of 85.71%, and specificity of 76.14%. The AUC for RDW was 0.742, with a standard error of 0.035 (95% CI: 0.674-0.811), Youden index of 0.48, sensitivity of 77.92%, and specificity of 69.32%. The AUC for CKD stage was 0.737, with a standard error of 0.032 (95% CI: 0.675-0.799), Youden index of 0.47, sensitivity of 92.21%, and specificity of 55.11%. Post-treatment patients with EASIX ≤ 3.18 had higher blood calcium levels and lower blood phosphorus levels compared to those with EASIX > 3.18, with significant differences (P < .05). EASIX demonstrates high predictive value in predicting CKD patients with CRS, suggesting its inclusion as an evaluation index.