Found programs: Scientific Research Project from the Institute of Health Big Data and Population Medicine , Insti- tute of Health and Medicine , Hefei Comprehensive National Science Center (No . JKS2023005) ;National Key Re- search and Development Program of China (No . 2020YFC2006502)
Authors：Zu Shuang1 , Yan Qiqi2 , Yang Le1 , Li Huixian1 , Li Xiude1 , Fan Yunshan1 , Zhang Bao1 , Wang Deguang2
Keywords：maintenance peritoneal dialysis; echocardiography; pulmonary hypertension; constituent analysis; fluid compartments; nomograms
DOI：10.19405/j.cnki.issn1000-1492.2025.11.023
〔Abstract〕 To identify the risk factors for pulmonary arterial hypertension (PAH) in maintenance peri- toneal dialysis (MPD) patients and to develop and validate a nomogram-based risk-prediction model . Methods A total of 168 hospitalized MPD patients from the Department of Nephrology were enrolled . Body-fluid composition was measured by bioelectrical impedance analysis , and pulmonary-artery systolic pressure (PASP) was assessed by echocardiography . Patients were randomly allocated into a training set and a validation set at 1 : 1 ratio . Variables with P < 0. 05 in multivariable Logistic regression in the training set were incorporated to construct a nomogram . The validation set was used to test the model ’s predictive performance . ROC curves , calibration curves , and deci- sion-curve analysis were applied to evaluate accuracy , consistency , and clinical usefulness of the model . Results Dialysis vintage ( OR : 1 . 038 , 95% CI: 1 . 008 - 1 . 069 , P = 0. 012) , hemoglobin level ( OR : 0. 961 , 95% CI: 0. 929 - 0. 994 , P = 0. 021) , and extracellular water/intracellular water ratio (E/I) (OR : 1 . 069 , 95% CI: 1 . 024 - 1 . 115 , P = 0. 002) were independent risk factors for PAH . ROC analysis yielded area under curve as 0. 867 (95% CI: 0. 782 - 0. 953) and 0. 808 (95% CI: 0. 714 - 0. 902) in the training and validation sets , respectively . Calibration plots showed that the predicted curves for both the training and validation sets closely overlapped with the ideal reference line , indicating that the nomogram risk-prediction model had good predictive performance . Deci- sion-curve analysis demonstrated that , within threshold ranges of 0. 13 - 0. 76 ( training set ) and 0. 20 - 0. 76 (val- idation set ) , clinical net benefit was substantial when interventions were guided by the nomogram . Conclusion Dialysis vintage , hemoglobin level , and fluid-overload index (E/I) are independent risk factors for PAH in MPD patients . The nomogram based on these parameters reliably predicts PAH risk and may aid clinical decision-mak- ing.