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Background Chronic kidney disease (CKD) confers a substantially elevated risk of cardiovascular (CV) mortality, primarily driven by heart failure (HF) and other CV complications. This study aimed to develop a nomogram for predicting incident HF and all-cause death in patients with CKD, and further identify individuals at high risk of these outcomes. Methods We prospectively recruited 440 patients with CKD stages 3–5 and preserved ejection fraction (LVEF) from a nephropathy center between November 2020 to September 2024. Baseline clinical and demographic characteristics, biochemical and echocardiographic parameters, and data from quality-of-life scales were collected. Key predictors were identified using univariate Cox regression, Lasso, Random Forest, and XGBoost algorithms; these identified predictors were then integrated into a nomogram via multivariate Cox regression. Model performance was assessed using the C-index, ROC analysis, and calibration plots. Results Over 29 months (IQR 24–35), 104(23.6%) patients met the primary composite endpoints, which included 62(14.1%) incident HF and 42(9.5%) all-cause death. After selecting variables through forward stepwise regression, age[HR 1.030, P = 0.016], growth differentiation factor 15(GDF-15) [HR 1.076, P < 0.001], lipoprotein(a)[Lp(a)] [HR = 1.011, P = 0.002], ferritin(FER) [HR = 1.009, P = 0.030], and EuroQol-5D (EQ-5D) score [HR 0.099, P = 0.015] were utilized to construct the nomogram. In the training cohort, the model achieved a C-index of 0.772. For temporal validation, time-dependent area under the ROC curve(AUC) values further confirmed its accuracy: 0.779 (95%CI, 0.696–0.863) at 24 months, 0.816(95%CI, 0.743–0.888) at 27 months, 0.836(95%CI, 0.768–0.903) at 32 months, and 0.850(95%CI, 0.771–0.929) at 36 months. Decision curve analysis (DCA) also demonstrated sustained clinical utility across a broad range of threshold probabilities. Conclusion This study identified specific predictors of HF and all-cause mortality in CKD patients. This model has enhanced predictive ability for early identification of these risks, thereby facilitating timely clinical interventions to improve the prognosis of CKD patients.

AbstractAimAn estimated 5%–25% of women with endometriosis have colorectal involvement. Colorectal resection is the most suitable surgical management for cases with large bowel infiltration. However, this method is also associated with the highest rate of postoperative complications. Data focusing on surgeon speciality and surgical outcomes are currently limited. The aim of this work was to evaluate the surgical characteristics and short‐term postoperative outcomes following colorectal resection for endometriosis according to surgeon speciality.MethodUsing the National Surgical Quality Improvement Program (NSQIP) database, we included women who underwent colorectal resection for endometriosis between 2012 and 2020. Surgeries by general/colorectal surgeons were compared with those by gynaecological surgeons. The primary outcome was major complications according to the Clavien–Dindo classification.ResultsAmong 745 colorectal resections, 82.3% were performed by general/colorectal surgeons and 17.7% by gynaecologists. Racial and ethnic characteristics differed between groups, but other baseline characteristics were comparable. General/colorectal surgeons performed fewer minimally invasive surgeries (29.9% vs. 58.3%, p < 0.001). General/colorectal surgery cases had lower rates of any postoperative complications and minor complications (14.8% vs. 29.5%, p < 0.001; 10.1% vs. 23.5%, p < 0.001), while major complication rates were similar. Multivariable regression showed no association between major complications and surgical speciality. In a propensity score‐matched analysis, no significant differences were found between the two cohorts.ConclusionMost colorectal resections are performed by general/colorectal surgeons while a minimally invasive approach is more common among gynaecologists. There were no significant differences in outcomes between the two groups after adjusting for confounding variables. This suggests considering a multidisciplinary or dual surgery team approach to deep infiltrative endometriosis requiring bowel resection.