title: Derivation and validation of a prediction score for acute kidney injury in patients hospitalized with acute heart failure in a Chinese cohort.
abstract: OBJECTIVE
  Acute kidney injury (AKI) is a common complication among patients hospitalized for acute heart failure (AHF), and is associated with increased mortality. The goal of this study was to derive and validate a prediction score for AKI in AHF patients.
  
  
  METHODS
  The hospital medical records of 1709 patients with AHF were reviewed. AKI was defined as an increase in serum creatinine (SCr) of ≥26.4 μmol/L or ≥50% within 48 h. A multivariate logistic regression analysis was undertaken to develop a new prediction score. The area under the receiver operating characteristic (ROC) curve and the Hosmer-Lemeshow goodness-of-fit statistic test were calculated to assess the discrimination and calibration of the prediction score, respectively.
  
  
  RESULTS
  Acute kidney injury developed in 32.2% of patients with AHF. Factors independently associated with the risk of AKI included: ≥70 years of age, ≥3 previous hospital admissions for AHF, systolic blood pressure <90 mmHg, serum sodium <130 mmol/L, heart functional class IV, proteinuria, SCr ≥104 μmol/L and intravenous furosemide dose ≥80 mg/day. A prediction score for AKI was derived based on the β coefficients of each risk factor. Patients with ≥8 points would be considered at high risk for development of AKI (55.1% incidence vs 18% in those with <8 points, P < 0.001). Both the derived and validated datasets showed adequate discrimination (area under ROC curve was 0.76 in both datasets) and calibration (Hosmer-Lemeshow statistic test, P = 0.98 and 0.13, respectively).
  
  
  CONCLUSIONS
  The newly derived and validated clinical prediction score may effectively predict AKI in the patients hospitalized with AHF.
authors.affiliation: Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yin-Na
authors.initials: YN
authors.lastname: Wang
authors.forename: Hong
authors.initials: H
authors.lastname: Cheng
authors.forename: Tong
authors.initials: T
authors.lastname: Yue
authors.forename: Yi-Pu
authors.initials: YP
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002681:China; D003404:Creatinine / Q000097:blood; D003661:Decision Support Techniques; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D003404:Creatinine