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Building and validation of a prognostic model for predicting extracorporeal circuit clotting in patients with continuous renal replacement therapy

  • Nephrology - Original Paper
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Abstract

Purpose

To develop a predictive model for circuit clotting in patients with continuous renal replacement therapy (CRRT).

Methods

A total of 425 cases were selected. 302 cases were used to develop a predictive model of extracorporeal circuit life span during CRRT without citrate anticoagulation in 24 h, and 123 cases were used to validate the model. The prediction formula was developed using multivariate Cox proportional-hazards regression analysis, from which a risk score was assigned.

Results

The mean survival time of the circuit was 15.0 ± 1.3 h, and the rate of circuit clotting was 66.6 % during 24 h of CRRT. Five significant variables were assigned a predicting score according to the regression coefficient: insufficient blood flow, no anticoagulation, hematocrit ≥0.37, lactic acid of arterial blood gas analysis ≤3 mmol/L and APTT < 44.2 s. The Hosmer–Lemeshow test showed no significant difference between the predicted and actual circuit clotting (R 2 = 0.232; P = 0.301).

Conclusions

A risk score that includes the five above-mentioned variables can be used to predict the likelihood of extracorporeal circuit clotting in patients undergoing CRRT.

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Acknowledgments

The study was supported by the National Key Technology R&D Program (No. 2011BAI10B08), the National Clinical Key Specialty Construction Preparatory Projects, and, in part, by Guangdong Provincial Scientific Planning Project #2010B031600157. This work for Wang was also supported, in part, by the Robert Wood Johnson Foundation Nurse Faculty Scholars Program.

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Southern Medical University, Guangzhou, 510080, China

    Xia Fu

  2. Department of Nephrology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, China

    Xia Fu, Xinling Liang, Li Song, Huigen Huang, Yuanhan Chen, Li Zhang, Zilin Quan & Wei Shi

  3. Nursing Systems Department, University of Texas Health Science Center at Houston School of Nursing, Houston, TX, 77030, USA

    Jing Wang

Authors
  1. Xia Fu
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  2. Xinling Liang
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  3. Li Song
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  4. Huigen Huang
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  5. Jing Wang
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  6. Yuanhan Chen
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  7. Li Zhang
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  8. Zilin Quan
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  9. Wei Shi
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Corresponding author

Correspondence to Wei Shi.

Additional information

Xia Fu and Xinling Liang have contributed equally to this work.

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Fu, X., Liang, X., Song, L. et al. Building and validation of a prognostic model for predicting extracorporeal circuit clotting in patients with continuous renal replacement therapy. Int Urol Nephrol 46, 801–807 (2014). https://doi.org/10.1007/s11255-014-0682-5

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  • DOI: https://doi.org/10.1007/s11255-014-0682-5

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