Effect Of Serum Phosphorus Clearance Rate On The Prognosis Of Patients With Septic Acute Renal Injury Receiving Continuous Renal Replacement Therapy

Objective:Patients with septic acute renal injury(SAKI)have higher mortality after continuous renal replacement therapy(CRRT).The purpose of this study is to explore the relationship between serum phosphorus clearance and the prognosis of SAKI patients treated with CRRT.Methods:The clinical data of 1144 patients with SAKI who were treated with CRRT in the second affiliated Hospital of Hainan Medical College from March 2016 to June2022 were analyzed retrospectively.According to 28 days after CRRT,the patients were divided into survival group and death group.The clinical information,biochemical indexes and blood phosphorus clearance rate of the two groups were compared.Binary Logistic regression analysis was used to analyze the influencing factors of 28-day death in SAKI patients treated with CRRT.A nomogram prediction model was established and evaluated according to the influencing factors.Results:In this study,it was found that BMI≥24kg/m~2,serum creatinine≥186umol/L,albumin≥25g/L and serum phosphorus clearance rate≥20.91%were protective factors for 28-day death in SAKI patients treated with CRRT,while APACHEⅡscore>35 and SOFA score>5 were risk factors(P<0.05).The above influencing factors were used to establish a nomogram prediction model to predict the28-day death of SAKI patients treated with CRRT.The results of ROC curve analysis showed that the AUC was 0.746[95%CI(0.718-0.775)],indicating that the nomogram prediction model had a good differentiation.The Bootstrap method was used to repeat sampling for 1000 times,and the results showed that the consistency index was 0.746.The calibration curve showed that the nomogram prediction model had better accuracy.The decision curve shows that when the probability threshold of the nomogram prediction model is 0.20-0.95,the net benefit rate is higher.Conclusion:1)Higher serum phosphorus clearance rate can improve the survival rate of SAKI patients treated with CRRT.2)The line chart prediction model has good differentiation,accuracy and clinical practicability to predict the 28-day mortality of SAKI patients treated with CRRT.