A nomogram prediction model for mild cognitive impairment in non-dialysis outpatient patients with chronic kidney disease

Abstract

Background The high prevalence of mild cognitive impairment (MCI) in non-dialysis individuals with chronic kidney disease (CKD) impacts their prognosis and quality of life. Objective This study aims to investigate the variables associated with MCI in non-dialysis outpatient patients with CKD and to construct and verify a nomogram prediction model. Methods 416 participants selected from two hospitals in Chengdu, between January 2023 and June 2023. They were categorized into two groups: the MCI group (n = 210) and the non-MCI (n = 206). Univariate and multivariate binary logistic regression analyses were employed to identify independent influences (candidate predictor variables). Subsequently, regression models was constructed, and a nomogram was drawn. The restricted cubic spline diagram was drawn to further analyze the relationship between the continuous numerical variables and MCI. Internally validated using a bootstrap resampling procedure. Results Among 416 patients, 210 (50.9%) had MCI. Logistic regression analysis revealed that age, educational level, occupational status, use of smartphones, sleep disorder, and hemoglobin were independent influencing factors of MCI (all p<.05). The model’s area under the curve was 0.926,95% CI (0.902, 0.951), which was a good discriminatory measure; the Calibration curve, the Hosmer–Lemeshow test, and the Clinical Decision Curve suggested that the model had good calibration and clinical benefit. Internal validation results showed the consistency index was 0.926, 95%CI (0.925, 0.927). Conclusion The nomogram prediction model demonstrates good performance and can be used for early screening and prediction of MCI in non-dialysis patients with CKD. It provides valuable reference for medical staff to formulate corresponding intervention strategies.