Screening of Influencing Factors for AKI Based on Lasso Regression

Authors

  • Ruijing Zhang College of Science, North China University of Science and Technology, China
  • Liwei Cui Department of Gastroenterology, Tangshan People's Hospital, China
  • Xuan Wang College of Science, North China University of Science and Technology, China
  • Jianshu Bian College of Science, North China University of Science and Technology, China
  • Zhongkai Zhang College of Science, North China University of Science and Technology, China
  • Tao Liu College of Science, North China University of Science and Technology, China

DOI:

https://doi.org/10.14738/bjhmr.102.14472

Keywords:

acute kidney injury, LASSO regression, prediction model, independent risk factors, data extraction

Abstract

Background:  Acute kidney injury (AKI) is one of the common critical diseases in hospitalized patients. There are many factors affecting acute kidney injury, difficult to obtain disease data, and short treatment time window. Early detection of AKI is critical to reducing mortality.  Methods: MIMIC-IV data were used to establish the prediction model of AKI in critical patients after operation. 1585 intensive care unit (ICU) patients were randomly divided into a training set (n=1109) and a prediction set (n=476) on a 7:3 basis. LASSO regression analysis was performed on the data, area under the operating characteristic curve (AUROC) was used to evaluate the model, and Hosmer-Lemeshow (HL) was used to test the degree of fit.  Results: Spinal injury, implantation of temporary cardiac pacemaker, esophageal disease, contrast media, diuretic, epinephrine, aminoglycoside antibiotics, tumor chemotherapy drugs, age, gender and red blood cells were determined to be independent risk factors for acute kidney injury. The AUROC of the model in the train set was 0.901 (95% confidence interval: 0.856~0.946). In the validation set, AUROC was 0.851 (95% confidence interval: 0.808~0.894). AUROC of the above two groups indicated that the model had a good degree of differentiation, which was greater than 70% in both groups. Hosmer-Lemeshow (HL) test showed P>0.05, indicating a good fit of the model. Conclusion: This prediction model can be used for the identification of post-operative AKI patients and provide a basis for clinicians or inpatients to more quickly self-measure the risk.

References

J. Ranstam and J. A. Cook, “LASSO regression,” British Journal of Surgery, vol. 105, no. 10, p. 1348, Sep. 2018, doi: 10.1002/bjs.10895.

R. Tibshirani, “Regression Shrinkage and Selection Via the Lasso,” Journal of the Royal Statistical Society: Series B (Methodological), vol. 58, no. 1, pp. 267–288, Jan. 1996, doi: 10.1111/j.2517-6161.1996. tb02080. x.

A. Camehl, “Penalized estimation of panel vector autoregressive models: A panel LASSO approach,” Int J Forecast, 2022, doi: 10.1016/j.ijforecast.2022.05.007.

L. Meier, S. Van De Geer, and P. Bühlmann, “The group lasso for logistic regression,” 2008.

F. Li, Y. Yang, and E. P. Xing, “From Lasso regression to Feature vector machine,” Dec. 2005.

V. Roth, “The generalized LASSO,” IEEE Trans Neural Netw, vol. 15, no. 1, pp. 16–28, Jan. 2004, doi: 10.1109/TNN.2003.809398.

R. Alhamzawi and H. T. M. Ali, “The Bayesian adaptive lasso regression,” Math Biosci, vol. 303, pp. 75–82, 2018, doi: 10.1016/j.mbs.2018.06.004.

H. Xu, C. Caramanis, and S. Mannor, “Robust regression and Lasso,” in Advances in Neural Information Processing Systems 21 - Proceedings of the 2008 Conference, 2009, pp. 1801–1808.

J. D. Lee, D. L. Sun, Y. Sun, and J. E. Taylor, “Exact post-selection inference, with application to the lasso,” The Annals of Statistics, vol. 44, no. 3, pp. 907–927, Jun. 2016, doi: 10.1214/15-AOS1371.

S. van de Geer, “On tight bounds for the Lasso,” Apr. 2018, [Online]. Available: http://arxiv.org/abs/1804.00989

P. M. Honoré, R. Jacobs, W. Boer, and O. Joannes-Boyau, “Sepsis and AKI: More complex than just a simple question of chicken and egg,” Intensive Care Medicine, vol. 37, no. 2. pp. 186–189, Feb. 2011. doi: 10.1007/s00134-010-2097-9.

M. Uehara et al., “Long-term surgical results of skip pedicle screw fixation for patients with adolescent idiopathic scoliosis: A minimum-ten-year follow-up study,” J Clin Med, vol. 9, no. 12, pp. 1–10, Dec. 2020, doi: 10.3390/jcm9124002.

R. U. Pliquett, D. Radler, A. Tamm, D. Greinert, R. Greinert, and M. Girndt, “Oliguric acute kidney injury as a main symptom of bradycardia and arteriosclerosis resolved by pacemaker implantation: A case report,” J Med Case Rep, vol. 8, no. 1, Sep. 2014, doi: 10.1186/1752-1947-8-289.

J. C. Schefold, G. Filippatos, G. Hasenfuss, S. D. Anker, and S. von Haehling, “Heart failure and kidney dysfunction: epidemiology, mechanisms and management,” Nat Rev Nephrol, vol. 12, no. 10, pp. 610–623, Oct. 2016, doi: 10.1038/nrneph.2016.113.

F. Lombardi, “Rate-dependent left ventricular filling time: A critical factor for adequate cardiac output,” Heart Rhythm, vol. 18, no. 7, pp. 1113–1114, Jul. 2021, doi: 10.1016/j.hrthm.2021.03.025.

J. C. Venter et al., “The Sequence of the Human Genome,” Science (1979), vol. 291, no. 5507, pp. 1304–1351, Feb. 2001, doi: 10.1126/science.1058040. 505

Z. Z. Liu et al., “Iodinated contrast media cause direct tubular cell damage, leading to oxidative stress, low nitric oxide, and impairment of tubuloglomerular feedback,” American Journal of Physiology-Renal Physiology, vol. 306, no. 8, pp. F864–F872, Apr. 2014, doi: 10.1152/ajprenal.00302.2013.

Y. Li and K. Ren, “The Mechanism of Contrast-Induced Acute Kidney Injury and Its Association with Diabetes Mellitus,” Contrast Media and Molecular Imaging, vol. 2020. Hindawi Limited, 2020. doi: 10.1155/2020/3295176.

A. Palazzuoli, G. Ruocco, S. Paolillo, and P. Perrone Filardi, “The use of diuretics in heart failure with congestion: we can’t judge a book by its cover,” ESC Heart Fail, vol. 6, no. 6, pp. 1222–1225, Dec. 2019, doi: 10.1002/ehf2.12515.

Y. Sirivatanauksorn et al., “Renal Dysfunction After Orthotopic Liver Transplantation,” Transplant Proc,

J. R. Privratsky et al., “Postoperative Acute Kidney Injury by Age and Sex: A Retrospective Cohort Association Study,” Anesthesiology, vol. 138, no. 2, pp. 184–194, Feb. 2023, doi: 10.1097/ALN.0000000000004436.

Downloads

Published

2023-04-30

How to Cite

Zhang, R., Cui, L., Wang, X., Bian, J., Zhang, Z., & Liu, T. (2023). Screening of Influencing Factors for AKI Based on Lasso Regression. British Journal of Healthcare and Medical Research, 10(2), 494–506. https://doi.org/10.14738/bjhmr.102.14472