The novel CKD-INF score for distinguishing infectious from non-infectious inflammation in patients with non-dialysis chronic kidney disease

一种用于区分非透析慢性肾脏病患者感染性炎症和非感染性炎症的新型CKD-INF评分

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Abstract

Our study analyzed 831 non-dialysis chronic kidney disease (CKD) patients admitted from January 2007 to January 2023, using 665 for creating and 166 for validating the CKD-Infectious Inflammation (CKD-INF) score. This score distinguishes inflammation types using logistic regression outcomes and aligns with the International Sepsis Definition Conference criteria. The study's participants had an average age of 76.2 ± 11.2 years, with 37% female and over half diagnosed with diabetes. The resulting score was as follows:[Formula: see text] where NLR refers to the neutrophil-to-lymphocyte ratio, CRP to C-reactive protein, and WBC indicates white blood cell count. CKD-INF exhibited a higher AUC of 0.85 (with a 95% CI of 0.82-0.87), higher sensitivity (75.3%) and specificity (82%) compared to its components including CRP. The CKD-INF score showed higher weighted κ values (0.57) for infection prediction at hospital admission than its individual components. In both training and validation groups, the CKD-INF score outperformed CRP as a predictor of infection in univariate and multivariate analyses. The CKD-INF score, derived from routine laboratory tests, can be an effective tool for predicting infections in CKD patients, potentially aiding in their early management.

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