Development and validation of a nomogram model for treatment failure in peritoneal dialysis-associated peritonitis patients

Background To assess the diagnostic utility of a nomogram constructed from combined inflammatory indicators in predicting treatment failure in patients with peritoneal dialysis-associated peritonitis (PDAP). Methods This retrospective, single-center observational study included 259 patients with PDAP, who were stratified into a cured group (n = 215) and a treatment failure group (n = 44) based on therapeutic outcomes. Clinical data from both groups were systematically analyzed. Results Variables were screened using the least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression analyses. The final predictive model incorporated the advanced lung cancer inflammation index (ALI), dialysis duration, pre-admission self-administration of antibiotics, dialysate WBC count on day 5, and serum albumin levels, and was visualized using a nomogram. The concordance index (C-index) for the modeling cohort was 0.93. Receiver operating characteristic analysis demonstrated areas under the curve of 0.93 (95% CI: 0.88–0.98) in the modeling cohort and 0.90 (95% CI: 0.82–0.99) in the validation cohort, indicating excellent discriminative performance and robust calibration of the nomogram in both cohorts. Conclusions The nomogram enables effective identification of treatment failure risk in patients with PDAP, thereby offering meaningful guidance for clinical management and decision-making.