INTRODUCTION Patients with end-stage renal disease receiving hemodialysis (HD) have a high morbidity and mortality rate associated with pulmonary hypertension (PH). A nomogram was developed to predict all-cause mortality in HD patients with PH. In this study, we aimed to validate the usefulness of this nomogram. METHODS A total of 274 HD patients with PH were hospitalized at the Affiliated Hospital of Xuzhou Medical University between January 2014 and June 2019 and followed up for 3 years. Echocardiography detected PH when the peak tricuspid regurgitation velocity (TRV) was more than 2.8 m/s. To evaluate the all-cause mortality for long-term HD patients with PH, Cox regression analysis was performed to determine the factors of mortality that were included in the prediction model. Next, the area under the receiver-operating characteristic curve (AUC-ROC) was used to assess the predictive power of the model. Calibration plots and decision curve analysis (DCA) were used to assess the accuracy of the prediction results and the clinical utility of the model. RESULTS The all-cause mortality rate was 29.1% throughout the follow-up period. The nomogram comprised six commonly available predictors: age, diabetes mellitus, cardiovascular disease, hemoglobin, left ventricular ejection fraction, and TRV. The 1-year, 2-year, and 3-year AUC-ROC values were 0.842, 0.800, and 0.781, respectively. The calibration curves revealed an excellent agreement with the nomogram, while the DCA demonstrated favorable clinical practicability. CONCLUSION The first developed nomogram for predicting all-cause mortality in HD patients with PH could guide clinical decision-making and intervention planning.

中文翻译：

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开发和验证列线图，用于预测患有肺动脉高压的血液透析患者的全因死亡率。

简介 接受血液透析（HD）的终末期肾病患者具有与肺动脉高压（PH）相关的高发病率和死亡率。开发了列线图来预测患有 PH 的 HD 患者的全因死亡率。在本研究中，我们旨在验证该列线图的有用性。方法 2014年1月至2019年6月在徐州医科大学附属医院住院治疗的HD合并PH患者274例，随访3年。当三尖瓣反流峰值速度（TRV）超过 2.8 m/s 时，超声心动图检测到 PH。为了评估长期 HD 合并 PH 患者的全因死亡率，进行了 Cox 回归分析以确定预测模型中包含的死亡率因素。接下来，使用接受者操作特征曲线下面积（AUC-ROC）来评估模型的预测能力。使用校准图和决策曲线分析（DCA）来评估预测结果的准确性和模型的临床实用性。结果整个随访期间全因死亡率为29.1%。该列线图包含六种常用的预测因子：年龄、糖尿病、心血管疾病、血红蛋白、左心室射血分数和 TRV。1年、2年和3年AUC-ROC值分别为0.842、0.800和0.781。校准曲线与列线图非常吻合，而 DCA 则表现出良好的临床实用性。结论 第一个开发的用于预测 HD 合并 PH 患者全因死亡率的列线图可以指导临床决策和干预计划。