急性肾损伤 (AKI) 通常发生在接触大剂量甲氨蝶呤 (HDMTX) 的淋巴瘤患者中，但我们可靠预测 AKI 的能力有限。本研究旨在开发和验证 HDMTX 暴露后预测 AKI 的模型。这项对连续接受 HDMTX 治疗的成人淋巴瘤患者进行的多中心回顾性研究，使用 LASSO 方法来确定治疗开始时可预测 7 天内发生 AKI 的因素HDMTX。然后该模型在一个独立队列中进行了验证。在衍生队列中（435 名独特的患者总共接受了 1,642剂量的 HDMTX）和验证队列（55 名接受总共 247 剂 HDMTX 的独特患者）中的 15.6%（95% CI 5.3%-24.8%）。在多变量模型中，与 HDMTX 后 AKI 显着相关的因素包括年龄≥55岁、男性和较低的 HDMTX 剂量。多变量分析中未发现与 AKI 显着相关但包含在最终模型中的其他因素包括体表面积、查尔森合并症指数和估计肾小球滤过率。该模型的 c 统计量在推导队列中为 0.72 (95% CI 0.69-0.75)，在验证队列中为 0.72 (95% CI 0.60-0.84)。该模型利用已确定的社会人口统计学和临床​​因素来预测 HDMTX 后 AKI成人淋巴瘤患者的给药。本文受版权保护。版权所有。

Acute kidney injury (AKI) commonly occurs in patients with lymphoma exposed to high-dose methotrexate (HDMTX), but our ability to reliably predict AKI is limited. This study sought to develop and validate a model for predicting AKI after HDMTX exposure.This multisite, retrospective study of consecutive adult lymphoma patients treated with HDMTX used the LASSO method to identify factors available at the outset of therapy that predicted incident AKI within 7 days following HDMTX. The model was then validated in an independent cohort.The incidence of AKI within 7 days following HDMTX was 21.6% (95% Confidence Interval (CI) 18.4%-24.8%) in the derivation cohort (435 unique patients who received a total of 1,642 doses of HDMTX) and 15.6% (95% CI 5.3%-24.8%) in the validation cohort (55 unique patients who received a total of 247 doses of HDMTX). Factors significantly associated with AKI after HDMTX in the multivariable model included age ≥ 55 years, male sex, and lower HDMTX dose number. Other factors that were not found to be significantly associated with AKI on multivariable analysis, but were included in the final model, were body surface area, Charlson Comorbidity Index, and estimated glomerular filtration rate. The c-statistic of the model was 0.72 (95% CI 0.69-0.75) in the derivation cohort and 0.72 (95% CI 0.60-0.84) in the validation cohort.This model utilizing identified sociodemographic and clinical factors is predictive of AKI following HDMTX administration in adult patients with lymphoma.This article is protected by copyright. All rights reserved.