Skip to main content
Top
Published in: BMC Medical Informatics and Decision Making 1/2023

Open Access 01-12-2023 | Acute Kidney Injury | Research

Short-term prognostic models for severe acute kidney injury patients receiving prolonged intermittent renal replacement therapy based on machine learning

Authors: Wenqian Wei, Zhefei Cai, Lei Chen, Weijie Yuan, Yingle Fan, Shu Rong

Published in: BMC Medical Informatics and Decision Making | Issue 1/2023

Login to get access

Abstract

Background

As an effective measurement for severe acute kidney injury (AKI), the prolonged intermittent renal replacement therapy (PIRRT) received attention. Also, machine learning has advanced and been applied to medicine. This study aimed to establish short-term prognosis prediction models for severe AKI patients who received PIRRT by machine learning.

Methods

The hospitalized AKI patients who received PIRRT were assigned to this retrospective case-control study. They were grouped based on survival situation and renal recovery status. To screen the correlation, Pearson’s correlation coefficient, partial ETA square, and chi-square test were applied, eight machine learning models were used for training.

Results

Among 493 subjects, the mortality rate was 51.93% and the kidney recovery rate was 30.43% at 30 days post-discharge, respectively. The indices related to survival were Sodium, Total protein, Lactate dehydrogenase (LDH), Phosphorus, Thrombin time, Liver cirrhosis, chronic kidney disease stage, number of vital organ injuries, and AKI stage, while Sodium, Total protein, LDH, Phosphorus, Thrombin time, Diabetes, peripherally inserted central catheter and AKI stage were selected to predict the 30-day renal recovery. Naive Bayes has a good performance in the prediction model for survival, Random Forest has a good performance in 30-day renal recovery prediction model, while for 90-day renal recovery prediction model, it’s K-Nearest Neighbor.

Conclusions

Machine learning can not only screen out indicators influencing prognosis of AKI patients receiving PIRRT, but also establish prediction models to optimize the risk assessment of these people. Moreover, attention should be paid to serum electrolytes to improve prognosis.
Appendix
Available only for authorised users
Literature
3.
go back to reference Hoste EA, Bagshaw SM, Bellomo R, et al. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med. 2015;41:1411–23.CrossRefPubMed Hoste EA, Bagshaw SM, Bellomo R, et al. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med. 2015;41:1411–23.CrossRefPubMed
4.
go back to reference Kaddourah A, Basu RK, Bagshaw SM, et al. Epidemiology of Acute kidney Injury in critically ill children and young adults. N Engl J Med. 2017;376:11–20.CrossRefPubMed Kaddourah A, Basu RK, Bagshaw SM, et al. Epidemiology of Acute kidney Injury in critically ill children and young adults. N Engl J Med. 2017;376:11–20.CrossRefPubMed
5.
go back to reference Wang AY, Bellomo R. Renal replacement therapy in the ICU: intermittent hemodialysis, sustained low-efficiency dialysis or continuous renal replacement therapy? Curr Opin Crit Care. 2018;24:437–42.CrossRefPubMed Wang AY, Bellomo R. Renal replacement therapy in the ICU: intermittent hemodialysis, sustained low-efficiency dialysis or continuous renal replacement therapy? Curr Opin Crit Care. 2018;24:437–42.CrossRefPubMed
6.
go back to reference Neves JB, Rodrigues FB, Castelão M, et al. Extended daily dialysis versus intermittent hemodialysis for acute kidney injury: a systematic review. J Crit Care. 2016;33:271–3.CrossRefPubMed Neves JB, Rodrigues FB, Castelão M, et al. Extended daily dialysis versus intermittent hemodialysis for acute kidney injury: a systematic review. J Crit Care. 2016;33:271–3.CrossRefPubMed
7.
go back to reference Cheng P, Waitman LR, Hu Y, et al. Predicting Inpatient Acute kidney Injury over different Time Horizons: how early and Accurate? AMIA Annu Symp Proc. 2017;2017:565–74.PubMed Cheng P, Waitman LR, Hu Y, et al. Predicting Inpatient Acute kidney Injury over different Time Horizons: how early and Accurate? AMIA Annu Symp Proc. 2017;2017:565–74.PubMed
8.
go back to reference Tomašev N, Glorot X, Rae JW, et al. A clinically applicable approach to continuous prediction of future acute kidney injury. Nature. 2019;572:116–9.CrossRefPubMedPubMedCentral Tomašev N, Glorot X, Rae JW, et al. A clinically applicable approach to continuous prediction of future acute kidney injury. Nature. 2019;572:116–9.CrossRefPubMedPubMedCentral
9.
go back to reference Chen X, Ma T. Sustained low-efficiency daily diafiltration for diabetic nephropathy patients with acute kidney injury. Med Princ Pract. 2014;23:119–24.CrossRefPubMedPubMedCentral Chen X, Ma T. Sustained low-efficiency daily diafiltration for diabetic nephropathy patients with acute kidney injury. Med Princ Pract. 2014;23:119–24.CrossRefPubMedPubMedCentral
10.
go back to reference Wei W, Rong S, Li X, et al. Short-term prognosis and influencing factors of patients with acute kidney injury treated with prolonged intermittent renal replacement therapy. Int J Clin Pract. 2021;75(5):e14020.CrossRefPubMed Wei W, Rong S, Li X, et al. Short-term prognosis and influencing factors of patients with acute kidney injury treated with prolonged intermittent renal replacement therapy. Int J Clin Pract. 2021;75(5):e14020.CrossRefPubMed
11.
go back to reference Richardson JTE. Eta squared and partial eta squared as measures of effect size in educational research[J]. Educational Res Rev. 2011;6(2):135–47.CrossRef Richardson JTE. Eta squared and partial eta squared as measures of effect size in educational research[J]. Educational Res Rev. 2011;6(2):135–47.CrossRef
12.
go back to reference Benesty J, Chen J, Huang Y, et al. Pearson correlation coefficient[M]//Noise reduction in speech processing. Berlin, Heidelberg: Springer; 2009. pp. 1–4. Benesty J, Chen J, Huang Y, et al. Pearson correlation coefficient[M]//Noise reduction in speech processing. Berlin, Heidelberg: Springer; 2009. pp. 1–4.
13.
14.
go back to reference Gao XP, Zheng CF, Liao MQ, et al. Admission serum sodium and potassium levels predict survival among critically ill patients with acute kidney injury: a cohort study. BMC Nephrol. 2019;20:311.CrossRefPubMedPubMedCentral Gao XP, Zheng CF, Liao MQ, et al. Admission serum sodium and potassium levels predict survival among critically ill patients with acute kidney injury: a cohort study. BMC Nephrol. 2019;20:311.CrossRefPubMedPubMedCentral
15.
go back to reference Lee SW, Baek SH, Ahn SY, et al. The Effects of Pre-Existing Hyponatremia and subsequent-developing acute kidney Injury on In-Hospital mortality: a retrospective cohort study. PLoS ONE. 2016;11:e0162990.CrossRefPubMedPubMedCentral Lee SW, Baek SH, Ahn SY, et al. The Effects of Pre-Existing Hyponatremia and subsequent-developing acute kidney Injury on In-Hospital mortality: a retrospective cohort study. PLoS ONE. 2016;11:e0162990.CrossRefPubMedPubMedCentral
16.
go back to reference Mezones-Holguin E, Niño-Garcia R, Herrera-Añazco P, et al. Possible association between dysnatremias and mortality during hospitalization in patients undergoing acute hemodialysis: analysis from a peruvian retrospective cohort. J Bras Nefrol. 2019;41:501–8.CrossRefPubMedPubMedCentral Mezones-Holguin E, Niño-Garcia R, Herrera-Añazco P, et al. Possible association between dysnatremias and mortality during hospitalization in patients undergoing acute hemodialysis: analysis from a peruvian retrospective cohort. J Bras Nefrol. 2019;41:501–8.CrossRefPubMedPubMedCentral
17.
go back to reference Moon H, Chin HJ, Na KY, et al. Hyperphosphatemia and risks of acute kidney injury, end-stage renal disease, and mortality in hospitalized patients. BMC Nephrol. 2019;20:362.CrossRefPubMedPubMedCentral Moon H, Chin HJ, Na KY, et al. Hyperphosphatemia and risks of acute kidney injury, end-stage renal disease, and mortality in hospitalized patients. BMC Nephrol. 2019;20:362.CrossRefPubMedPubMedCentral
18.
go back to reference Burra V, Nagaraja PS, Singh NG, et al. Early prediction of acute kidney injury using serum phosphorus as a biomarker in pediatric cardiac surgical patients. Ann Card Anaesth. 2018;21:455–9.CrossRefPubMedPubMedCentral Burra V, Nagaraja PS, Singh NG, et al. Early prediction of acute kidney injury using serum phosphorus as a biomarker in pediatric cardiac surgical patients. Ann Card Anaesth. 2018;21:455–9.CrossRefPubMedPubMedCentral
19.
go back to reference Sadan O, Singbartl K, Kandiah PA, et al. Hyperchloremia is Associated with Acute kidney Injury in patients with subarachnoid hemorrhage. Crit Care Med. 2017;45:1382–8.CrossRefPubMed Sadan O, Singbartl K, Kandiah PA, et al. Hyperchloremia is Associated with Acute kidney Injury in patients with subarachnoid hemorrhage. Crit Care Med. 2017;45:1382–8.CrossRefPubMed
20.
go back to reference Saran R, Robinson B, Abbott KC, et al. Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2017;69:A7–a8. US Renal Data System 2016 Annual Data Report:. Saran R, Robinson B, Abbott KC, et al. Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2017;69:A7–a8. US Renal Data System 2016 Annual Data Report:.
Metadata
Title
Short-term prognostic models for severe acute kidney injury patients receiving prolonged intermittent renal replacement therapy based on machine learning
Authors
Wenqian Wei
Zhefei Cai
Lei Chen
Weijie Yuan
Yingle Fan
Shu Rong
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2023
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-023-02231-2

Other articles of this Issue 1/2023

BMC Medical Informatics and Decision Making 1/2023 Go to the issue