Developing and validating a machine learning model to predict multidrug-resistant Klebsiella pneumoniae-related septic shock

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 15

Published: Jan. 10, 2025

Multidrug-resistant Klebsiella pneumoniae (MDR-KP) infections pose a significant global healthcare challenge, particularly due to the high mortality risk associated with septic shock. This study aimed develop and validate machine learning-based model predict of MDR-KP-associated shock, enabling early stratification targeted interventions. A retrospective analysis was conducted on 1,385 patients MDR-KP admitted between January 2019 June 2024. The cohort randomly divided into training set (n = 969) validation 416). Feature selection performed using LASSO regression Boruta algorithm. Seven learning algorithms were evaluated, logistic chosen for its optimal balance performance robustness against overfitting. overall incidence shock 16.32% (226/1,385). predictive identified seven key factors: procalcitonin (PCT), sepsis, acute kidney injury, intra-abdominal infection, use vasoactive medications, ventilator weaning failure, mechanical ventilation. demonstrated excellent performance, an area under receiver operating characteristic curve (AUC) 0.906 in 0.865 set. Calibration robust, Hosmer-Lemeshow test results P 0.065 (training) 0.069 (validation). Decision indicated substantial clinical net benefit. presents validated, high-performing offering valuable tool decision-making. Prospective, multi-center studies are recommended further evaluate applicability effectiveness diverse settings.

Language: Английский

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Associations between the intake of single and multiple dietary vitamins and depression risk among populations with chronic kidney disease

Frontiers in Nutrition, Journal Year: 2025, Volume and Issue: 12

Published: Feb. 4, 2025

Background The effects of multivitamin exposure on depression among patients with chronic kidney disease (CKD) have not been thoroughly explored. This study aimed to explore the individual vitamin intakes and joint effect intake multiple vitamins (including A, B 1 , 2 6 12 C, D, E, K) risk in participants CKD. Methods A total 3,123 CKD (weighted n = 25,186,480) from National Health Nutrition Examination Survey database 2007 2014 were included. Weighted multivariate logistic regression models utilized analyze associations dietary risk. Additionally, Bayesian kernel machine (BKMR) weighted quantile sum (WQS) performed evaluate nine Results overall prevalence was approximately 11.3% participants. In fully adjusted model, high (OR: 0.54, 95% CI: 0.40–0.74), 0.67, 0.48–0.95), 0.70, 0.49–0.99), D 0.67. 0.48–0.94), K 0.61, 0.44–0.85) associated a reduced likelihood depression. BKMR WQS showed that had significant negative depression, being largest contributor two models. Lastly, reflected mixed 0.82, 0.69–0.99). Conclusion High are low Furthermore, co-exposure is crucial factor contributing this population.

Language: Английский

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Prevalence of and Factors Associated With Incidental Chronic Kidney Disease in Patients Newly Diagnosed With Type 2 Diabetes Mellitus

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 18, 2025

Objective: The objective of this study was to detect the prevalence incidental chronic kidney disease (CKD) in patients newly diagnosed with type 2 diabetes (T2D). Method: This a cross-sectional conducted from July 2023 November 2024, at Faiha Specialized Diabetes, Endocrine, and Metabolism Center Al-Rafidain Basrah, southern Iraq. A total 202 drug-naïve T2D were included. baseline clinical biochemical characteristics for inclusion. CKD by measuring estimated glomerular filtration rate (eGFR) urine albumin creatinine ratio (UACR). Results: mean age included 49.1±12 years. 68 (33.7%) based on GFR <60 mL/minute/1.73 m2 and/or UACR ≥ 30 mg/g. categories G1, 2, G3a, 3b prevalent 71.3%, 24.2%, 3.0%, 1.5%, respectively. For albuminuria, 31.2% had 10-30 mg/g, 22.8% 30-300 7.9% higher than 300 stepwise binary regression analysis showed that patients' HbA1c levels factors significantly associated CKD. Conclusion: is one-third T2D. Early screening highly recommended as it will affect overall management.

Language: Английский

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SGLT-2i—A Useful Tool for Real-Life Metabolic and Body Weight Control in Type 2 Diabetes Mellitus Patients

Medicina, Journal Year: 2025, Volume and Issue: 61(3), P. 548 - 548

Published: March 20, 2025

Background and Objectives: Elevated blood sugar poses an increasingly significant challenge to healthcare systems worldwide. We aimed assess the efficacy of SGLT-2i class in achieving metabolic control patients with T2DM within a real-world standard-of-care regimen. Material Methods: A prospective analysis was conducted over 6 months including individuals receiving care outpatient department, baseline assessments follow-ups at 3 months. Results: total 280 were assessed, mean age 63.69 ± 9.16, 53.9% which males, DM duration 9.06 5.64 years, varying from 24 years. Discussion: Real-world evidence bridges gap between guidelines practice. It emphasizes need overcome clinical inertia order optimize patient outcomes contributes body supporting fixed-dose combinations managing associated comorbidities. Conclusions: demonstrate therapeutic impact setting. This medication not only positively influences glycemic weight but also reduces CV risk factors visceral adiposity.

Language: Английский

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The Dual Burden: Exploring Cardiovascular Complications in Chronic Kidney Disease

Biomolecules, Journal Year: 2024, Volume and Issue: 14(11), P. 1393 - 1393

Published: Oct. 31, 2024

Chronic kidney disease (CKD) represents a significant global health challenge, affecting millions of individuals and leading to substantial morbidity mortality. This review aims explore the epidemiology, cardiovascular complications, management strategies associated with CKD, emphasizing importance preventing early intervention. CKD is primarily driven by conditions such as diabetes mellitus, hypertension, diseases, which often coexist exacerbate renal impairment. Effective requires multifaceted approach, including lifestyle modifications, pharmacological interventions, regular monitoring. Dietary changes, sodium restriction controlled intake phosphorus potassium, play vital role in preserving function. Pharmacological therapies, particularly angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), emerging agents like SGLT2 have shown efficacy slowing progression improving patient outcomes. Furthermore, patients undergoing dialysis face increased risk, necessitating comprehensive address both cardiac health. As landscape treatment evolves, ongoing research into novel therapeutic options personalized medical approaches are essential. underscores urgent need for awareness, education, effective preventive measures mitigate burden enhance quality life affected individuals.

Language: Английский

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The Clinical and Economic Burden of Chronic Kidney Disease in Poland: Inside Patient-Level Microsimulation Modelling of CKD

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 14(1), P. 54 - 54

Published: Dec. 26, 2024

Background/Objectives: Chronic kidney disease (CKD) is associated with increased annual costs, the highest costs attributable to renal replacement therapy (RRT). These will rise as prevalence increases. Therefore, forecasting future and economic burden of CKD, particularly in underdiagnosed populations, may provide valuable insights policymakers looking at strategies implement interventions delay CKD progression. Methods: As part Inside study, this work used epidemiological data generate a virtual population representative Poland that progressed through microsimulation 1-year increments between 2022 2027. This was assess clinical burdens Poland. Results: Between 2027, percentage individuals projected increase from 10.7% 11.3%. Only 30.1% be diagnosed During time, total healthcare cost pre-RRT predicted decrease slightly $73 million $62 million. However, by 23.1% when including RRT. Conclusions: study shows worsen upcoming years. The implementation policies enhance early detection initiation treatments slow progression should implemented reduce number requiring

Language: Английский

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