Development and Validation of a Nomogram for Predicting Acute Kidney Injury in Acute Respiratory Distress Syndrome

Area of Science:

• Nephrology
• Critical Care Medicine
• Pulmonology

Background:

• Acute kidney injury (AKI) is a severe complication of acute respiratory distress syndrome (ARDS).
• Existing tools for early AKI prediction in ARDS patients are limited.
• This study addresses the need for improved AKI risk assessment in ARDS.

Purpose of the Study:

• To develop and validate a predictive nomogram for AKI in patients with ARDS.
• To identify key clinical risk factors for AKI development in this population.
• To provide a tool for early risk stratification and clinical decision-making.

Main Methods:

• Retrospective cohort study of 944 ARDS patients.
• Development (n=708) and validation (n=236) cohorts utilized.
• Logistic regression identified risk factors; a nomogram was constructed and validated using AUC, calibration plots, and DCA.

Main Results:

• Nine independent risk factors for AKI identified: age, diabetes mellitus, immunosuppression, invasive mechanical ventilation, elevated LDH, elevated BNP, total bilirubin, baseline creatinine, and prothrombin time.
• The nomogram showed excellent discrimination (AUC 0.904 development, 0.892 validation).
• Favorable clinical utility was confirmed by calibration plots and DCA.

Conclusions:

• A validated nine-factor nomogram for AKI prediction in ARDS patients was developed.
• The nomogram incorporates easily accessible clinical variables.
• This tool can aid in the early identification of AKI risk and support clinical management decisions.