{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:20:56Z","timestamp":1783567256691,"version":"3.55.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Identifying high-risk patients for contrast-associated acute kidney injury (CA-AKI) helps to take early preventive interventions. The current study aimed to establish and validate an online pre-procedural nomogram for CA-AKI in patients undergoing coronary angiography (CAG).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective dataset, 4,295 patients undergoing CAG were enrolled and randomized into the training or testing dataset with a split ratio of 8:2. Optimal predictors for CA-AKI were determined by Least Absolute Shrinkage and Selection Operator (LASSO) and Random Forest (RF) algorithm. Nomogram was developed and deployed online. The discrimination and accuracy of the nomogram were evaluated by receiver operating characteristic (ROC) and calibration analysis, respectively. Clinical usefulness was estimated by decision curve analysis (DCA) and clinical impact curve (CIC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 755 patients (17.1%) was diagnosed with CA-AKI. 7 pre-procedural predictors were identified and integrated into the nomogram, including age, gender, hemoglobin, N-terminal of the prohormone brain natriuretic peptide, neutrophil-to-lymphocyte ratio, cardiac troponin I, and loop diuretics use. The ROC analyses showed that the nomogram had a good discrimination performance for CA-AKI in the training dataset (area under the curve, AUC = 0.766, 95%CI [0.737 to 0.794]) and testing dataset (AUC = 0.737, 95%CI [0.693 to 0.780]). The nomogram was also well-calibrated in both the training dataset (<jats:italic>P<\/jats:italic> = 0.965) and the testing dataset (<jats:italic>P<\/jats:italic> = 0.789). Good clinical usefulness was identified by DCA and CIC. Finally, this model was deployed in a web server for public use (<jats:ext-link>https:\/\/duanbin-li.shinyapps.io\/DynNomapp\/<\/jats:ext-link>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An easy-to-use pre-procedural nomogram for predicting CA-AKI was established and validated in patients undergoing CAG, which was also deployed online.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.839856","type":"journal-article","created":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T05:42:46Z","timestamp":1646977366000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["An Online Pre-procedural Nomogram for the Prediction of Contrast-Associated Acute Kidney Injury in Patients Undergoing Coronary Angiography"],"prefix":"10.3389","volume":"9","author":[{"given":"Duanbin","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hangpan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinrui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maoning","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menghan","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhezhe","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guosheng","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongwu","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1016\/j.jacc.2019.06.012","article-title":"Coronary artery disease and transcatheter aortic valve replacement: JACC state-of-the-art review.","volume":"74","author":"Faroux","year":"2019","journal-title":"J Am Coll Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1161\/CIRCULATIONAHA.117.031907","article-title":"Clinical outcomes and cost\u2013effectiveness of fractional flow reserve\u2013guided percutaneous coronary intervention in patients with stable coronary artery disease: three-year follow-up of the FAME 2 trial (fractional flow reserve versus angiography for multivessel evaluation).","volume":"137","author":"Fearon","year":"2018","journal-title":"Circulation."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1001\/jamainternmed.2016.6656","article-title":"Update on percutaneous coronary intervention in stable coronary artery disease.","volume":"176","author":"Mitchell","year":"2016","journal-title":"JAMA Intern Med."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.120.008962","article-title":"Management of percutaneous coronary intervention complications: algorithms from the 2018 and 2019 seattle percutaneous coronary intervention complications conference.","volume":"13","author":"Doll","year":"2020","journal-title":"Circ Cardiovasc Interv."},{"key":"B5","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1016\/j.jacc.2016.05.099","article-title":"Contrast\u2013induced acute kidney injury.","volume":"68","author":"McCullough","year":"2016","journal-title":"J Am Coll Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2527","DOI":"10.1007\/s00330-011-2225-0","article-title":"Contrast induced nephropathy: updated ESUR contrast media safety committee guidelines.","volume":"21","author":"Stacul","year":"2011","journal-title":"Eur Radiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1038\/nrneph.2016.196","article-title":"Understanding and preventing contrast-induced acute kidney injury.","volume":"13","author":"Fahling","year":"2017","journal-title":"Nat Rev Nephrol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"417","DOI":"10.7326\/M15-1402","article-title":"Comparative effect of contrast media type on the incidence of contrast\u2013induced nephropathy: a systematic review and meta-analysis.","volume":"164","author":"Eng","year":"2016","journal-title":"Ann Intern Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1016\/j.amjcard.2004.03.008","article-title":"Impact of nephropathy after percutaneous coronary intervention and a method for risk stratification.","volume":"93","author":"Bartholomew","year":"2004","journal-title":"Am J Cardiol."},{"key":"B10","doi-asserted-by":"crossref","first-page":"2146","DOI":"10.1056\/NEJMra1805256","article-title":"Contrast\u2013associated acute kidney injury.","volume":"380","author":"Mehran","year":"2019","journal-title":"N Engl J Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1016\/j.cjca.2017.01.018","article-title":"Risk prediction models for contrast\u2013induced acute kidney injury accompanying cardiac catheterization: systematic review and meta\u2013analysis.","volume":"33","author":"Allen","year":"2017","journal-title":"Can J Cardiol."},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1186\/s12944-021-01489-7","article-title":"Effect of statins on post\u2013contrast acute kidney injury: a multicenter retrospective observational study.","volume":"20","author":"Lin","year":"2021","journal-title":"Lipids Health Dis."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-94910-1","article-title":"Association of the classification and severity of heart failure with the incidence of contrast\u2013induced acute kidney injury.","volume":"11","author":"Xu","year":"2021","journal-title":"Sci Rep."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1016\/j.jacc.2004.06.068","article-title":"A simple risk score for prediction of contrast\u2013induced nephropathy after percutaneous coronary intervention: development and initial validation.","volume":"44","author":"Mehran","year":"2004","journal-title":"J Am Coll Cardiol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"W1","DOI":"10.7326\/M14-0698","article-title":"Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): explanation and elaboration.","volume":"162","author":"Moons","year":"2015","journal-title":"Ann Intern Med."},{"key":"B16","first-page":"S15","article-title":"2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021.","year":"2021","journal-title":"Diabetes Care."},{"key":"B17","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1161\/01.hyp.36.5.801","article-title":"Systolic and diastolic blood pressure, pulse pressure, and mean arterial pressure as predictors of cardiovascular disease risk in Men.","volume":"36","author":"Sesso","year":"2000","journal-title":"Hypertension."},{"key":"B18","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.2337\/dc17-0179","article-title":"Prevalence of and risk factors for diabetic peripheral neuropathy in youth with type 1 and type 2 diabetes: search for diabetes in youth study.","volume":"40","author":"Jaiswal","year":"2017","journal-title":"Diabetes Care."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-22260-6","article-title":"Association between homocysteine and conventional predisposing factors on risk of stroke in patients with hypertension.","volume":"8","author":"Pang","year":"2018","journal-title":"Sci Rep."},{"key":"B20","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1136\/heart.88.6.559","article-title":"Measuring left ventricular volume and ejection fraction with the biplane Simpson\u2019s method.","volume":"88","author":"Otterstad","year":"2002","journal-title":"Heart."},{"key":"B21","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1002\/ejhf.612","article-title":"Superior performance of N-terminal pro brain natriuretic peptide for diagnosis of acute decompensated heart failure in an Asian compared with a Western setting.","volume":"19","author":"Ibrahim","year":"2017","journal-title":"Eur J Heart Fail."},{"key":"B22","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate.","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1002\/(sici)1097-0258(19970228)16:4<385::aid-sim380>3.0.co;2-3","article-title":"The lasso method for variable selection in the Cox model.","volume":"16","author":"Tibshirani","year":"1997","journal-title":"Stat Med."},{"key":"B24","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/A:1010933404324","article-title":"Random forests.","volume":"45","author":"Breiman","year":"2001","journal-title":"Mach Learn."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.730453","article-title":"Predicting all\u2013cause mortality risk in atrial fibrillation patients: a novel LASSO-Cox model generated from a prospective dataset.","volume":"8","author":"Chen","year":"2021","journal-title":"Front Cardiovasc Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"2800","DOI":"10.1200\/JCO.2008.19.7418","article-title":"Comparison of models to predict nonsentinel lymph node status in breast cancer patients with metastatic sentinel lymph nodes: a prospective multicenter study.","volume":"27","author":"Coutant","year":"2009","journal-title":"J Clin Oncol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"562","DOI":"10.2307\/2333203","article-title":"Two further applications of a model for binary regression.","volume":"45","author":"Cox","year":"1958","journal-title":"Biometrika."},{"key":"B28","first-page":"369","article-title":"Protective effect of salvianolate on early contrast-induced renal injury in patients with coronary artery intervention.","volume":"28","author":"Ren","year":"2020","journal-title":"Chin. J. Interv. Cardiol"},{"key":"B29","first-page":"574","article-title":"Short-term hemofiltration for prevention of contrast induced nephropathy in patients with stage 3 or stage 4 chronic kidney disease.","volume":"27","author":"Wang","year":"2019","journal-title":"Chin. J. Interv. Cardiol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-28088-4","article-title":"Development and validation of nomogram to predict acute kidney injury in patients with acute myocardial infarction treated invasively.","volume":"8","author":"Zhou","year":"2018","journal-title":"Sci Rep."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1974","DOI":"10.1016\/S0140-6736(21)02326-6","article-title":"A contemporary simple risk score for prediction of contrast\u2013associated acute kidney injury after percutaneous coronary intervention: derivation and validation from an observational registry.","volume":"398","author":"Mehran","year":"2021","journal-title":"Lancet."},{"key":"B32","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1536\/ihj.16-213","article-title":"A nomogram to predict contrast induced nephropathy in patients undergoing percutaneous coronary intervention.","volume":"58","author":"Hu","year":"2017","journal-title":"Int Heart J."},{"key":"B33","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1177\/0003319716669429","article-title":"Gender difference in the risk of contrast\u2013induced nephropathy in patients undergoing coronary angiography or percutaneous coronary intervention.","volume":"68","author":"Barbieri","year":"2017","journal-title":"Angiology."},{"key":"B34","first-page":"59","article-title":"Neutrophil-to-lymphocyte ratio predicts contrast-induced acute kidney injury in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.","volume":"14","author":"Tan\u0131k","year":"2019","journal-title":"J Tehran Heart Cent."},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006259","article-title":"Association of N-terminal pro-brain natriuretic peptide with contrast-induced acute kidney injury and long\u2013term mortality in patients with heart failure and mid\u2013range ejection fraction: an observation study.","volume":"96","author":"Wang","year":"2017","journal-title":"Medicine (Baltimore)."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.1093\/eurheartj\/ehu063","article-title":"Contrast\u2013induced acute kidney injury after primary percutaneous coronary intervention: results from the HORIZONS-AMI substudy.","volume":"35","author":"Narula","year":"2014","journal-title":"Eur Heart J."},{"key":"B37","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1016\/j.amjcard.2018.06.012","article-title":"Anemia (Hemoglobin = 13 g\/dL) as a risk factor for contrast\u2013induced acute kidney injury following coronary angiography.","volume":"122","author":"Sreenivasan","year":"2018","journal-title":"Am J Cardiol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"F796","DOI":"10.1152\/ajprenal.00206.2006","article-title":"Acute decrease in renal microvascular PO2 during acute normovolemic hemodilution.","volume":"292","author":"Johannes","year":"2007","journal-title":"Am J Physiol Renal Physiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1053\/ajkd.1998.v32.pm9669426","article-title":"Oxygen free radicals and contrast nephropathy.","volume":"32","author":"Katholi","year":"1998","journal-title":"Am J Kidney Dis."},{"key":"B40","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.1681\/asn.2011111078","article-title":"Mechanisms of anemia in CKD.","volume":"23","author":"Babitt","year":"2012","journal-title":"J Am Soc Nephrol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1159\/000187090","article-title":"Potential deleterious effect of furosemide in radiocontrast nephropathy.","volume":"62","author":"Weinstein","year":"1992","journal-title":"Nephron."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1416","DOI":"10.1056\/NEJM199411243312104","article-title":"Effects of saline, mannitol, and furosemide on acute decreases in renal function induced by radiocontrast agents.","volume":"331","author":"Solomon","year":"1994","journal-title":"N Engl J Med."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.839856\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T05:42:52Z","timestamp":1646977372000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.839856\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,11]]},"references-count":42,"alternative-id":["10.3389\/fmed.2022.839856"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.839856","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,11]]},"article-number":"839856"}}