Work

Developing a Nomogram Prediction Model for Dietary Behavior Adherence in Hemodialysis Patients

Year: 2025

Type: article

Abstract: Objective: To develop a nomogram prediction model for dietary behavior adherence in hemodialysis (HD) patients, providing a simple and accurate tool for individualized risk prediction and supporting effective intervention strategies. Methods: A total of 236 HD patients admitted from January 2022 to January 2024 were retrospectively included as the modeling group, and another 121 HD patients admitted from January 2024 to May 2025 served as the validation group. Patients in both groups were classified into compliance and non-compliance groups according to their dietary adherence. Lasso regression and multivariate logistic analysis were used to identify independent predictors and construct the nomogram. Internal and external validation were performed using ROC curves, the Hosmer–Lemeshow (H–L) test, calibration curves, and decision curve analysis (DCA). Results: Among the 236 patients in the modeling group, 73 (30.93%) showed dietary non-compliance. Age, years on dialysis, educational level, dietary knowledge, social support, family support, and self-care ability significantly differed between the two groups (P< 0.05). Seven variables selected by Lasso regression were entered into logistic analysis. Age, years on dialysis, and poor self-care ability were risk factors for non-adherence, whereas higher educational level, better dietary knowledge, stronger social support, and family support were protective factors (P< 0.05). The internal validation yielded an AUC of 0.884 and an H–L χ 2 of 7.346 (P=0.713), while the external validation showed an AUC of 0.902 and an H–L χ 2 of 7.342 (P=0.726). DCA indicated high clinical utility within threshold probabilities of 0.10– 0.83 (internal) and 0.15– 0.84 (external). Conclusion: Age, years on dialysis, educational level, dietary knowledge, social support, family support, and self-care ability are key factors influencing dietary adherence in HD patients. The nomogram based on these variables demonstrated good discrimination and clinical benefit, aiding early identification of high-risk patients and supporting individualized dietary management. Keywords: hemodialysis, dietary behavior, compliance, influencing factors, nomogram

Source: Patient Preference and Adherence

DOI: 10.2147/ppa.s559708

Authors: Yanyan Liu, Xiurong Wen

Institution: Ganzhou People's Hospital

Language: English

Topic: Dialysis and Renal Disease Management

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836