Objective To construct a prediction model of sleep disorder (SD) in patients with maintenance hemodialysis (MHD) based on Lasso-Nomogram model, and to verify the efficacy of the prediction model. Methods A total of 198 patients with chronic renal failure (CRF) who underwent MHD in our hospital were selected and categorized into SD and non-SD groups according to whether SD occurred 6 months after MHD. We compared the clinical data of the two groups, analyzed the influencing factors for SD, and constructed a nomogram prediction model of SD according to the predictive factors. Results In the sixth month after MHD, 92 CRF patients developed SD, with the SD incidence of 46.46% (92/198). Logistic analysis showed that age (OR=2.152, 95% CI：1.246～3.718), skin itching (OR=6.209, 95% CI：2.051～18.796), depression (OR=3.715, 95% CI：1.531～9.013), urea clearance index (Kt/V) (OR=0.302, 95% CI：0.154～0.592), blood phosphorus (OR=2.274, 95% CI：1.236～4.185), calcium and phosphorus product (OR=3.210, 95% CI：1.517～6.792), serum copeptin (OR=6.816, 95% CI：2.317～20.048), α-amylase (OR=5.277, 95% CI：1.953～14.257), and 25-(OH)D3 (OR=0.381, 95% CI：0.186～0.780) were the influencing factors for SD (P<0.001). A nomogram prediction model of SD was constructed based on the nine indicators screened by Lasso and logistic analyses. Using this model, the area under the curve (AUC) for the occurrence of SD in CRF patients with MHD was 0.928 (95% CI：0.892～0.963), with the prediction sensitivity and specificity of 81.13% and 90.11% respectively. Conclusion This nomogram prediction model of SD in CRF patients with MHD based on the influencing factors for SD has higher predictive efficacy and better clinical effect in predicting SD risk.
SUN Hai-Yun
. Construction of a prediction model for sleep disorders in maintenance hemodialysis patients based on Lasso-Nomogram model and verification of the model[J]. Chinese Journal of Blood Purification, 2024
, 23(07)
: 529
-533
.
DOI: 10.3969/j.issn.1671-4091.2024.07.009
[1] Ammirati AL.Chronic Kidney Disease[J].Rev Assoc Med Bras (1992),2020,66Suppl 1(Suppl 1):s03-s09.DOI:10.1590/1806-9282.66.S1.3.
[2] Fang J,Guo Y,Yin W,et al.Neoxanthin alleviates the chronic renal failure-induced aging and fibrosis by regulating inflammatory process[J].Int Immunopharmacol,2023,114(1):109429.DOI:10.1016/j.intimp.2022.109429.
[3] Dai P,Chang W,Xin Z,et al.Retrospective Study on the Influencing Factors and Prediction of Hospitalization Expenses for Chronic Renal Failure in China Based on Random Forest and LASSO Regression[J].Front Public Health,2021,9(1):678276.DOI:10.3389/fpubh.2021.678276.
[4] Dai L,Lu C,Liu J,et al.Impact of twice- or three-times-weekly maintenance hemodialysis on patient outcomes: A multicenter randomized trial[J].Medicine (Baltimore),2020,99(20):e20202.DOI:10.1097/MD.0000000000020202.
[5] Xu S,Zou D,Tang R,et al.Levels of trace blood elements associated with severe sleep disturbance in maintenance hemodialysis patients[J].Sleep Breath,2021,25(4):2007-2013.DOI:10.1007/s11325-021-02336-w.
[6] 刘美君,崔文鹏,苗里宁,等.维持性血液透析患者睡眠障碍的研究进展[J].中国全科医学,2020,23(29):3712-3718,3728.DOI:10.12114/j.issn.1007-9572.2020.00.107.
[7] Xu R,Miao L,Ni J,et al.Risk factors and prediction model of sleep disturbance in patients with maintenance hemodialysis: A single center study[J].Front Neurol,2022,13(1):955352.DOI:10.3389/fneur.2022.955352.
[8] 张伟杰,方庆珊,秦艳东.分析维持性血液透析患者睡眠障碍的影响因素[J].世界睡眠医学杂志,2022,9(1):39-41.DOI:10.3969/j.issn.2095-7130.2022.01.012.
[9] Expert Panel on Urologic Imaging.ACR appropriateness criteria? renal failure[J].J Am Coll Radiol,2021,18(5S):S174-S188.DOI:10.1016/j.jacr.2021.02.019.
[10] Han Q,Liu B,Lin S,et al.Pittsburgh sleep quality index score predicts all-cause mortality in Chinese dialysis patients[J].Int Urol Nephrol,2021,53(11):2369-2376.DOI:10.1007/s11255-021-02842-6.
[11] 中华医学会,中华医学会杂志社,中华医学会消化病学分会,等.慢性便秘基层诊疗指南（2019年）[J].中华全科医师杂志,2020,19(12):1100-1107.DOI:10.3760/cma.j.cn114798-20201030-01109.
[12] Ionescu CG,Talasman AA,Badarau IA.Somatization and Sleep Quality on Patients with Comorbid Anxiety/Depression[J].Maedica (Bucur),2021,16(2):246-254.DOI:10.26574/maedica.2021.16.2.246.
[13] 田秀珣,张蓝月,雷艳,等.维持性血液透析患者失眠及影响因素分析:一项多中心、横断面、观察性研究[J].临床肾脏病杂志,2022,22(7):546-552.DOI:10.3969/j.issn.1671-2390.2022.07.004.
[14] 潘璐璐,邵国建,王泽敏,等.维持性血液透析患者睡眠障碍的相关危险因素分析[J].温州医科大学学报,2023,53(3):245-249.DOI:10.3969/j.issn.2095-9400.2023.03.012.
[15] Iranzo A.Parasomnias and Sleep-Related Movement Disorders in Older Adults[J].Sleep Med Clin,2022,17(2):295-305.DOI:10.1016/j.jsmc.2022.02.005.
[16] Erdem Y,Altunay ?K,?zkur E,et al.The Association between Melatonin Levels and Sleep Quality in Patients with Pruritus: A Potential Biomarker on a Candidate Future Treatment[J].Indian J Dermatol,2021,66(6):609-615.DOI:10.4103/ijd.ijd_31_21.
[17] Carneiro ER,Azoubel LA,Dias RC,et al.Correlation of sleep quality and cardiac autonomic modulation in hemodialysis patients[J].Sleep Sci,2022,15(Spec 1):59-64.DOI:10.5935/1984-0063.20200126.
[18] 罗俊.维持性血液透析患者抑郁状态的危险因素研究[D].遵义医科大学,2021.DOI:10.27680/d.cnki.gzyyc.2021.000394.
[19] Orasan OH,Muresan F,Mot A,et al.Hemodialysis Patients with Pruritus and Insomnia Have Increased Risk of Death[J].Blood Purif,2020,49(4):419-425.DOI:10.1159/000505147.
[20] 苗月亭,薛现军,刘敏洁,等.基于Logistic回归模型分析120例慢性肾衰竭维持性血液透析患者钙磷乘积达标率的相关影响因素[J].中国医学工程,2022,30(6):90-92.DOI:10.19338/j.issn.1672-2019.2022.06.022.
[21] 张敏,周建芳,胡婷,等.维持性血液透析患者睡眠障碍的影响因素分析[J].中国中西医结合肾病杂志,2021,22(4):349-351.DOI:10.3969/j.issn.1009-587X.2021.04.020.
[22] 朱方方,吕倩,许宝玲,等.维持性血液透析患者睡眠障碍影响因素的Meta分析[J].现代临床护理,2022,21(9):67-77.DOI:10.3969/j.issn.1671-8283.2022.09.011.
[23] Dressle RJ,Feige B,Spiegelhalder K,et al.HPA axis activity in patients with chronic insomnia: A systematic review and meta-analysis of case-control studies[J].Sleep Med Rev,2022,62(1):101588.DOI:10.1016/j.smrv.2022.101588.
[24] 胡婷,宋璇,葛义俊,等.慢性失眠患者血清交感神经活性标志物水平与睡眠质量和认知功能的相关性研究[J].中华神经科杂志,2020,53(5):335-340.DOI:10.3760/cma.j.cn113694-20191111-00704.
[25] 石磊,王瑞霞,田津伟.血清维生素D低水平睡眠障碍老年人睡眠质量、认知能力及HPA轴相关激素指标观察[J].山东医药,2022,62(11):50-52.DOI:10.3969/j.issn.1002-266X.2022.11.012.
