The novel CKD-INF score for distinguishing infectious from non-infectious inflammation in patients with non-dialysis chronic kidney disease
Abstract Our study analyzed 831 non-dialysis chronic kidney disease (CKD) patients admitted from January 2007 to January 2023, using 665 for creating and 166 for validating the CKD-Infectious Inflammation (CKD-INF) score. This score distinguishes inflammation types using logistic regression outcomes...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-04-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-99584-7 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850284407910301696 |
|---|---|
| author | Ilia Beberashvili Khieralla Shaheen Elad Nizri Kobi Stav Shai Efrati |
| author_facet | Ilia Beberashvili Khieralla Shaheen Elad Nizri Kobi Stav Shai Efrati |
| author_sort | Ilia Beberashvili |
| collection | DOAJ |
| description | Abstract Our study analyzed 831 non-dialysis chronic kidney disease (CKD) patients admitted from January 2007 to January 2023, using 665 for creating and 166 for validating the CKD-Infectious Inflammation (CKD-INF) score. This score distinguishes inflammation types using logistic regression outcomes and aligns with the International Sepsis Definition Conference criteria. The study’s participants had an average age of 76.2 ± 11.2 years, with 37% female and over half diagnosed with diabetes. The resulting score was as follows: $$\begin{gathered} {\text{CKD}} \text{-} {\text{INF}} = 1.8*{\text{CRP}}\left( {{\text{mg}}/{\text{L}}} \right) + 3.3*{\text{NLR}} + 7.9*{\text{WBC}}\left( {{\text{K}}/{{\upmu \text{L}}}} \right) \hfill \\ \quad \quad \quad \quad \quad \quad\;\;\; + 172.1*{\text{Fever}} \ge 38\,{^\circ }{\text{C}}\left( {{\text{no}} = 0,{\text{yes}} = 1} \right), \hfill \\ \end{gathered}$$ where NLR refers to the neutrophil-to-lymphocyte ratio, CRP to C-reactive protein, and WBC indicates white blood cell count. CKD-INF exhibited a higher AUC of 0.85 (with a 95% CI of 0.82–0.87), higher sensitivity (75.3%) and specificity (82%) compared to its components including CRP. The CKD-INF score showed higher weighted κ values (0.57) for infection prediction at hospital admission than its individual components. In both training and validation groups, the CKD-INF score outperformed CRP as a predictor of infection in univariate and multivariate analyses. The CKD-INF score, derived from routine laboratory tests, can be an effective tool for predicting infections in CKD patients, potentially aiding in their early management. |
| format | Article |
| id | doaj-art-cab27601ba35448c9af3d5be88aef3f7 |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-cab27601ba35448c9af3d5be88aef3f72025-08-20T01:47:34ZengNature PortfolioScientific Reports2045-23222025-04-011511910.1038/s41598-025-99584-7The novel CKD-INF score for distinguishing infectious from non-infectious inflammation in patients with non-dialysis chronic kidney diseaseIlia Beberashvili0Khieralla Shaheen1Elad Nizri2Kobi Stav3Shai Efrati4Nephrology Division, Yitzhak Shamir Medical CenterInternal Department D, Yitzhak Shamir Medical CenterNephrology Division, Yitzhak Shamir Medical CenterUrology Department, Yitzhak Shamir Medical CenterNephrology Division, Yitzhak Shamir Medical CenterAbstract Our study analyzed 831 non-dialysis chronic kidney disease (CKD) patients admitted from January 2007 to January 2023, using 665 for creating and 166 for validating the CKD-Infectious Inflammation (CKD-INF) score. This score distinguishes inflammation types using logistic regression outcomes and aligns with the International Sepsis Definition Conference criteria. The study’s participants had an average age of 76.2 ± 11.2 years, with 37% female and over half diagnosed with diabetes. The resulting score was as follows: $$\begin{gathered} {\text{CKD}} \text{-} {\text{INF}} = 1.8*{\text{CRP}}\left( {{\text{mg}}/{\text{L}}} \right) + 3.3*{\text{NLR}} + 7.9*{\text{WBC}}\left( {{\text{K}}/{{\upmu \text{L}}}} \right) \hfill \\ \quad \quad \quad \quad \quad \quad\;\;\; + 172.1*{\text{Fever}} \ge 38\,{^\circ }{\text{C}}\left( {{\text{no}} = 0,{\text{yes}} = 1} \right), \hfill \\ \end{gathered}$$ where NLR refers to the neutrophil-to-lymphocyte ratio, CRP to C-reactive protein, and WBC indicates white blood cell count. CKD-INF exhibited a higher AUC of 0.85 (with a 95% CI of 0.82–0.87), higher sensitivity (75.3%) and specificity (82%) compared to its components including CRP. The CKD-INF score showed higher weighted κ values (0.57) for infection prediction at hospital admission than its individual components. In both training and validation groups, the CKD-INF score outperformed CRP as a predictor of infection in univariate and multivariate analyses. The CKD-INF score, derived from routine laboratory tests, can be an effective tool for predicting infections in CKD patients, potentially aiding in their early management.https://doi.org/10.1038/s41598-025-99584-7InflammationInfectionC-reactive proteinNeutrophil to lymphocyte ratioChronic kidney disease |
| spellingShingle | Ilia Beberashvili Khieralla Shaheen Elad Nizri Kobi Stav Shai Efrati The novel CKD-INF score for distinguishing infectious from non-infectious inflammation in patients with non-dialysis chronic kidney disease Scientific Reports Inflammation Infection C-reactive protein Neutrophil to lymphocyte ratio Chronic kidney disease |
| title | The novel CKD-INF score for distinguishing infectious from non-infectious inflammation in patients with non-dialysis chronic kidney disease |
| title_full | The novel CKD-INF score for distinguishing infectious from non-infectious inflammation in patients with non-dialysis chronic kidney disease |
| title_fullStr | The novel CKD-INF score for distinguishing infectious from non-infectious inflammation in patients with non-dialysis chronic kidney disease |
| title_full_unstemmed | The novel CKD-INF score for distinguishing infectious from non-infectious inflammation in patients with non-dialysis chronic kidney disease |
| title_short | The novel CKD-INF score for distinguishing infectious from non-infectious inflammation in patients with non-dialysis chronic kidney disease |
| title_sort | novel ckd inf score for distinguishing infectious from non infectious inflammation in patients with non dialysis chronic kidney disease |
| topic | Inflammation Infection C-reactive protein Neutrophil to lymphocyte ratio Chronic kidney disease |
| url | https://doi.org/10.1038/s41598-025-99584-7 |
| work_keys_str_mv | AT iliabeberashvili thenovelckdinfscorefordistinguishinginfectiousfromnoninfectiousinflammationinpatientswithnondialysischronickidneydisease AT khierallashaheen thenovelckdinfscorefordistinguishinginfectiousfromnoninfectiousinflammationinpatientswithnondialysischronickidneydisease AT eladnizri thenovelckdinfscorefordistinguishinginfectiousfromnoninfectiousinflammationinpatientswithnondialysischronickidneydisease AT kobistav thenovelckdinfscorefordistinguishinginfectiousfromnoninfectiousinflammationinpatientswithnondialysischronickidneydisease AT shaiefrati thenovelckdinfscorefordistinguishinginfectiousfromnoninfectiousinflammationinpatientswithnondialysischronickidneydisease AT iliabeberashvili novelckdinfscorefordistinguishinginfectiousfromnoninfectiousinflammationinpatientswithnondialysischronickidneydisease AT khierallashaheen novelckdinfscorefordistinguishinginfectiousfromnoninfectiousinflammationinpatientswithnondialysischronickidneydisease AT eladnizri novelckdinfscorefordistinguishinginfectiousfromnoninfectiousinflammationinpatientswithnondialysischronickidneydisease AT kobistav novelckdinfscorefordistinguishinginfectiousfromnoninfectiousinflammationinpatientswithnondialysischronickidneydisease AT shaiefrati novelckdinfscorefordistinguishinginfectiousfromnoninfectiousinflammationinpatientswithnondialysischronickidneydisease |