A machine learning-based approach for predicting renal function recovery in general ward patients with acute kidney injury.

IF 2.9 3区 医学 Q1 UROLOGY & NEPHROLOGY
Kidney Research and Clinical Practice Pub Date : 2024-07-01 Epub Date: 2024-06-17 DOI:10.23876/j.krcp.23.330
Nam-Jun Cho, Inyong Jeong, Yeongmin Kim, Dong Ok Kim, Se-Jin Ahn, Sang-Hee Kang, Hyo-Wook Gil, Hwamin Lee
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Abstract

Background: Acute kidney injury (AKI) is a significant challenge in healthcare. While there are considerable researches dedicated to AKI patients, a crucial factor in their renal function recovery, is often overlooked. Thus, our study aims to address this issue through the development of a machine learning model to predict restoration of kidney function in patients with AKI.

Methods: Our study encompassed data from 350,345 cases, derived from three hospitals. AKI was classified in accordance with the Kidney Disease: Improving Global Outcomes. Criteria for recovery were established as either a 33% decrease in serum creatinine levels at AKI onset, which was initially employed for the diagnosis of AKI. We employed various machine learning models, selecting 43 pertinent features for analysis.

Results: Our analysis contained 7,041 and 2,929 patients' data from internal cohort and external cohort respectively. The Categorical Boosting Model demonstrated significant predictive accuracy, as evidenced by an internal area under the receiver operating characteristic (AUROC) of 0.7860, and an external AUROC score of 0.7316, thereby confirming its robustness in predictive performance. SHapley Additive exPlanations (SHAP) values were employed to explain key factors impacting recovery of renal function in AKI patients.

Conclusion: This study presented a machine learning approach for predicting renal function recovery in patients with AKI. The model performance was assessed across distinct hospital settings, which revealed its efficacy. Although the model exhibited favorable outcomes, the necessity for further enhancements and the incorporation of more diverse datasets is imperative for its application in real- world.

基于机器学习的急性肾损伤普通病房患者肾功能恢复预测方法。
背景:急性肾损伤(AKI)是医疗保健领域的一项重大挑战,给社会带来了沉重负担。尽管有大量研究致力于 AKI 和 AKI 患者的康复,但他们的预后中的一个关键因素往往被忽视。因此,我们的研究旨在通过开发一种基于机器学习的方法来预测 AKI 患者肾功能的恢复情况,从而解决这一问题:我们的研究涵盖了来自两家医院的 350,345 个病例的数据。方法:我们的研究涵盖了来自两家医院的 350,345 个病例的数据:改善全球结果》对 AKI 进行分类。痊愈的标准是在 AKI 发病时血清肌酐水平下降 33% 或下降到低于基线值(最初用于诊断 AKI)。我们采用了各种机器学习模型,选择了 43 个相关特征进行分析:我们的分析分别包含了来自内部队列和外部队列的 7,041 和 2,929 名患者的数据。分类提升模型显示了显著的预测准确性,内部接收者工作特征曲线下面积(AUROC)为 0.7860,外部 AUROC 得分为 0.7316,从而证实了其预测性能的稳健性。采用SHapley Additive exPlanations值解释了影响AKI患者肾功能恢复的关键因素,突出强调了尿比重升高、体温和血磷水平等因素:本研究提出了一种新颖的机器学习框架,用于预测 AKI 患者的肾功能恢复情况,加深了对影响恢复的关键变量的理解。该模型的临床适用性在不同的医院环境中进行了评估,结果显示其疗效存在差异。虽然该模型取得了良好的效果,但要将其应用于现实世界中,还需要进一步改进并纳入更多样化的数据集。
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来源期刊
CiteScore
4.60
自引率
10.00%
发文量
77
审稿时长
10 weeks
期刊介绍: Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.
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