The significantly lower concentration of serum inorganic phosphorus, serum?potassium, serum magnesium, serum calcium and serum sodium and higher concentration of BUN were observed in IVIG-resistant group in our study, which indicated that kidney vasculitis might exert negative effect on renal function and tubular reabsorption

The significantly lower concentration of serum inorganic phosphorus, serum?potassium, serum magnesium, serum calcium and serum sodium and higher concentration of BUN were observed in IVIG-resistant group in our study, which indicated that kidney vasculitis might exert negative effect on renal function and tubular reabsorption. The final risk factors selected to undergo multivariate analysis for predicting IVIG-resistance, including RDW, platelet count, P-LYM, TBA, albumin, serum sodium level, D-CALs and age. serum sodium level, D-CALs and age. The new model appeared to be superior to those previous models for KD human population in Chongqing city. Intro Kawasaki disease (KD) is an acute autoimmune systemic vasculitis disease, primarily influencing young children and characterized by bilateral conjunctival swelling, atypical rash, etc. Probably the most severe result of KD is definitely coronary artery lesions (CALs), which is definitely associated with the prognosis of KD1. Quick treatment with high-dose (2?g/kg) intravenous immunoglobulin (IVIG) could significantly reduce manifestations of KD and CALs. However, 10C20% of the KD individuals are resistant to IVIG2,3. Therefore, after initial IVIG administration, CHMFL-BTK-01 recrudescent or prolonged fever may occur and further treatment is required at 48?hours after the initial use of IVIG, such as the second administration of IVIG, corticosteroids, etc4. The incidence of CALs in IVIG-resistant KD group was significantly higher than that in the IVIG-sensitive KD group (71% versus 5%, p? ?0.0001)5. Moreover, studies have suggested that IVIG-resistance is an self-employed risk element for huge coronary aneurysms6,7. Consequently, to early detect the IVIG-resistant KD individuals and improve prognosis, it is important to recognize the risk possibility of IVIG-resistance and take appropriate regimens early. The etiology and underlying biology of KD have not been completely elucidated. It is still challenging for pediatricians to quickly diagnose KD, especially when diagnosing the children with atypical or incomplete KD. Many studies possess tried to explore the methods to recognize the disease more effectively and accurately. Earlier studies reported that C-reactive protein, neutrophils, serum sodium, CHMFL-BTK-01 aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, erythrocyte sedimentation rate (ESR), age, etc. are the risk factors of IVIG-resistance5,8C12. Based on those risk factors, some prediction models for IVIG-resistant KD were founded, including Fukunishi3, Egami8, Kobayashi9 and Sano5 rating system from Japan and Yang10 of the optimal value of lambda was eleven. Among the eleven variables, eight indicators offered statistical significance and were utilized for multivariate logistic regression analysis (Table?2). The self-employed risk factors for IVIG-resistant KD were higher RDW, lower platelet count, lower P-LYM, higher TBA, lower albumin, lower serum sodium level, higher degree of CALs and more youthful age. The OR ideals (95%Cl) of those risk factors were outlined in Table?2. CHMFL-BTK-01 Table 2 The OR (odds ratio) values of the self-employed risk factors for IVIG-resistant Kawasaki disease. thead th rowspan=”2″ colspan=”1″ Risk factors /th th colspan=”2″ rowspan=”1″ Multiple logistic regression analysis after LASSO /th th colspan=”2″ rowspan=”1″ Multiple logistic regression analysis using the nine signals with statistical significance /th th rowspan=”1″ colspan=”1″ OR value (95% confidence interval) /th th rowspan=”1″ colspan=”1″ em P /em -value /th th rowspan=”1″ colspan=”1″ OR value (95% confidence interval) /th th rowspan=”1″ colspan=”1″ em P /em -value /th /thead RDW1.181 (1.099C1.266) 0.0011.189 (1.106C1.274) 0.001PLT0.999 (0.998C1.000)0.0480.999 (0.998C1.000)0.013P-LYM0.066 (0.017C0.246) 0.0010.052 (0.013C0.193) 0.001TBA1.004 (1.002C1.007)0.0011.006 (1.003C1.008) 0.001Na0.954 (0.914C0.997)0.0340.946 (0.907C0.988)0.011Albumin0.942 (0.916C0.968) 0.0010.940 (0.915C0.967) 0.001D-CALs12.255 (1.654C3.107) 0.0012.197 (1.616C3.019) 0.001D-CALs22.703 (1.550C4.587) 0.0012.815 (1.630C4.738) 0.001D-CALs35.085 (1.099C17.078)0.0175.696 (1.234C19.078)0.010BUN1.071 (0.996C1.149)0.057//Urobilirubin1.444 (0.727C2.804)0.285//Urine protein1.385 (0.929C2.027)0.101//Age0.462 (0.302C0.726)0.0010.478 (0.313C0.750)0.001 Open in a separate window LASSO, least complete shrinkage and selection operator; RDW, red blood cell distribution CHMFL-BTK-01 width; PLT, lower platelet count; P-LYM, percentage of lymphocyte; TBA, total bile acid; Na, serum sodium level; D-CALs1, minor degree of coronary artery lesions; D-CALs2, moderate degree of coronary artery lesions; D-CALs3, severe degree of coronary artery lesions; BUN, blood urea nitrogen. Based on the above result, a nomogram was derived for personal risk probability of IVIG-resistance (Fig.?1). The underlying logistic model is definitely given by the following equation: math xmlns:mml=”http://www.w3.org/1998/Math/MathML” id=”M2″ display=”block” overflow=”scroll” mstyle mathsize=”8pt” mtable columnalign=”remaining” mtr mtd mi L /mi mi o /mi mi g /mi mo ? /mo mi o /mi mi d /mi mi d /mi mi s /mi mspace width=”.25em” /mspace mi o /mi mi f /mi mspace width=”.25em” /mspace mi h /mi mi a /mi mi v /mi mi i /mi mi n /mi mi g /mi mspace width=”.25em” /mspace mi I /mi mi V /mi mi I /mi mi G /mi mspace width=”.25em” /mspace mi r /mi mi e /mi mi s /mi mi i /mi mi s /mi mi t /mi mi e /mi mi n /mi mi c /mi mi e /mi mo = /mo mn 5.772 /mn mspace width=”.25em” /mspace mo + /mo mn 0.173 /mn mo /mo mi R /mi mi D /mi mi W /mi mo + /mo mrow mo stretchy=”true” ( /mo mrow mo ? /mo mn 0.001 /mn /mrow mo stretchy=”true” ) /mo CHMFL-BTK-01 /mrow mo /mo mi P /mi mi L /mi mi T /mi /mtd /mtr mtr mtd mspace width=”1em” /mspace mo + /mo mspace width=”.25em” /mspace mrow mo stretchy=”true” ( /mo mrow mo ? /mo mn 2.966 /mn /mrow mo stretchy=”true” ) /mo /mrow mo /mo mi P /mi mo ? /mo mi L /mi mi Y /mi mi M /mi mo + /mo mn 0.006 /mn mo /mo mi T /mi mi B /mi mi A /mi mo + /mo mrow mo stretchy=”true” ( /mo mrow mo ? /mo mn 0.055 /mn /mrow mo stretchy=”true” ) /mo /mrow mo /mo mi N /mi mi a /mi mo + /mo mrow mo stretchy=”true” ( /mo mrow mo ? /mo mn 0.061 /mn /mrow mo stretchy=”true” ) /mo /mrow mo /mo mi A /mi mi l /mi mi b /mi mi u /mi mi m /mi mi i /mi mi n /mi mspace width=”.25em” /mspace /mtd /mtr mtr mtd mspace width=”1em” /mspace mo + /mo mn 0.787 /mn mo /mo mi D /mi mo ? /mo mi C /mi mi A /mi mi L /mi mi s /mi mn 1 /mn mo + /mo mn 1.035 /mn mo /mo mi D /mi mo ? /mo mi C /mi mi A /mi mi L /mi mi s /mi mn 2 /mn mo + /mo mn 1.740 /mn mo /mo mi D /mi mo ? /mo mi C /mi mi A /mi mi L /mi mi s /mi mn 3 /mn mo + /mo mo stretchy=”false” ( /mo mo ? /mo mn 0.738 /mn mo stretchy=”false” ) /mo mo /mo mi A /mi mi g /mi mi e /mi /mtd /mtr /mtable /mstyle PCDH12 /math Open in a separate window Number 1 The nomogram for personal risk.