|
|
Diagnosis of minimal change disease based on optimized logistic regression model |
Zhang Xingzhen1, Huang Jian1, Xi Weiwei2, Ying Jun1 |
1 Jinhua Hospital Affiliated to Zhejiang University School of Medicine, Jinhua 321001, China;
2 Department of Nephrology, Shao Yifu Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou 310016, China
|
|
|
Abstract Objective Minimal change disease (MCD) is one of the main causes of idiopathic nephrotic syndrome (NS). Renal biopsy has been the gold standard for clinical diagnosis of MCD. Because renal biopsy causes substantial harm to patients, this study aims to establish a mathematical diagnostic model based on biological parameters to achieve noninvasive diagnosis of MCD. Methods The AUC was used to evaluate the biological parameters for the differentiation between the MCD group and the control group in 798 patients with idiopathic nephrotic syndrome. Logistic regression methods were used to establish diagnostic models and calculate the Youden index, sensitivity, specificity, and accuracy to assess the clinical diagnostic value of the model. Results The AUC of seven biological parameters was greater than 0.70, including albumin (AUC=0.821), total cholesterol (AUC=0.800), plasma fibrinogen (AUC=0.706), high density lipoprotein cholesterol (AUC=0.747), low density lipoprotein cholesterol (AUC=0.777), total protein (AUC=0.824), and thrombin time (AUC=0.804). Further analysis showed that total cholesterol, high density lipoprotein cholesterol and thrombin time were risk factors for MCD, and total protein was a protective factor for MCD. The optimized logistic regression model includes four biological parameters (total cholesterol, high density lipoprotein cholesterol, total protein, and thrombin time). The model has an AUC of 0.870, an Youden index at the optimal cutoff point of 0.617, a sensitivity of 80.43%, a specificity of 81.31%, an accuracy of 81.26%, and an associated criterion of 0.073 5, which means that if PRE2>0.073 5, MCD patients will be determined, otherwise they will be other kidney disease patients. Conclusion The 4-parameter logistic regression model established in this study has high accuracy and can be used for clinical diagnosis of MCD.
|
Received: 09 April 2020
|
|
|
|
[1]WALDMAN M, JOHN CREW R, VALERI A M, et al. Adult minimal-change disease: Clinical characteristics, treatment, and outcomes[J]. Clin J Am Soc Nephrol, 2007, 2(3):445-453.
[2]FLOEGE J, AMANN K. Primary glomerulonephritides[J]. Lancet, 2016, 387(10032):2036-2048.
[3]FIORENTINO M, BOLIGNANO D, TESAR V, et al. Renal biopsy in 2015: From epidemiology to evidence-based indications[J]. Am J Nephrol, 2016, 43(1):1-19.
[4]VERDE E, QUIROGA B, RIVERA F, et al. Renal biopsy in very elderly patients: Data from the Spanish Registry of Glomerulonephritis[J]. Am J Nephrol, 2012, 35(3):230-237.
[5]ZHU H Y, HAN Q X, ZHANG D, et al. A diagnostic model for minimal change disease based on biological parameters[J]. PeerJ, 2018, 6:e4237.
[6]NOONE D G, IIJIMA K, PAREKH R. Idiopathic nephrotic syndrome in children[J]. Lancet, 2018, 392(10141):61-74.
[7]KERLIN B A, AYOOB R, SMOYER W E. Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic disease[J]. Clin J Am Soc Nephrol, 2012, 7(3):513-520.
[8]VIVARELLI M,MASSELLA L,RUGGIERO B,et al.Minimal Change Disease[J] .Clin J Am Soc Nephrol,2017,12(2): 332-345.
[9]杨琛,陈香美,蔡广研,等.成人微小病变肾病综合征发生急性肾损伤的相关影响因素分析[J].中华肾病研究电子杂志,2018,7(1):28-33.
[10]周海燕,陈如,辜娜.糖尿病肾病并发蛋白尿的危险因素分析[J].中国医院统计,2019,26(4):266-268.
[11]钟红霞.慢性肾衰竭患者血液透析后发生医院感染的危险因素分析[J].中国医院统计,2018,25(1):29-32.
[12]李芹芹,潘晓霞.成人肾小球微小病变的病理特征[J].临床与实验病理学杂志,2017,33(10):1138-1142.
|
[1] |
Xiang Fengming, Zhou Jie, Zhang Danyun, Zhang Xian. Application of lasso-logistic model in the analysis of septic shock influencing factors after percutaneous nephrolithotripsy[J]. journal1, 2020, 27(6): 502-505. |
[2] |
Bao Xiaoqiang, Liu Meina, Wang Yupeng. . Analysis of influence factors of breast cancer treatment quality based on evaluation indicators
[J]. journal1, 2020, 27(5): 397-402. |
[3] |
Zhou Peimin, Su Zhongliang, Xu Qing, Zheng Shu. Influencing factors of surgical site infection after total hip arthroplasty using decision tree and logistic regression model[J]. journal1, 2019, 26(6): 404-407. |
[4] |
Li Jingkun, Li Xi, Liu Meina. Analysis of influencing factors on non-small cell lung cancer treatment quality based on evaluation indicators[J]. journal1, 2018, 25(6): 405-409. |
[5] |
Li Jiandi, Shen Zhihua. Non-conditional logistic regression analysis on the influencing factors of the adverse reaction of ciprofloxacin injection[J]. journal1, 2016, 23(6): 412-414. |
[6] |
Xia Jikai, Shi Dewen, Yang Qinglin, Wang Peiyuan, Zheng Weibo, Li Jun, Yang Minghao. Analysis of status quo of the initiative and its influence factors of Yantai public physical examination[J]. journal1, 2016, 23(3): 192-195. |
|
|
|
|