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ARTIFICIAL INTELLIGENCE IN NEPHROLOGY IN 2019

Artificial intelligence approaches to improve kidney care

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From Nature Reviews Nephrology

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Artificial intelligence is increasingly being used to improve diagnosis and prognostication for acute and chronic kidney diseases. Studies with this objective published in 2019 relied on a variety of available data sources, including electronic health records, intraoperative physiological signals, kidney ultrasound imaging, and digitized biopsy specimens.

Key advances

  • A deep recurrent neural network model using data from electronic health records enables the prediction of inpatient episodes of acute kidney injury (AKI) with lead times of up to 48 hours5.

  • Integrating intraoperative physiological signals into an AKI risk model that dynamically integrates preoperative and intraoperative data improves the prediction of postoperative AKI6.

  • A convolutional deep learning model enables the noninvasive classification of chronic kidney disease stage and estimated glomerular filtration rate using kidney ultrasound images8.

  • A convolutional neural network trained for multiclass segmentation enables automated analysis of transplant biopsy and nephrectomy samples9.

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Fig. 1: A conceptual framework for the future use of artificial intelligence in nephrology.

Change history

  • 13 January 2020

    In the original html and PDF versions of this article published online, the 2 in 1.73 m2 was incorrectly formatted as a reference citation. This error has been corrected in print and online.

References

  1. United States Department of Health and Human Services. Advancing American kidney health. HHS https://aspe.hhs.gov/system/files/pdf/262046/AdvancingAmericanKidneyHealth.pdf (2019).

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  4. Al-Jaghbeer, M. et al. Clinical decision support for in-hospital AKI. J. Am. Soc. Nephrol. 29, 654–660 (2018).

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  5. Tomašev, N. et al. A clinically applicable approach to continuous prediction of future acute kidney injury. Nature 572, 116–119 (2019).

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  6. Adhikari, L. et al. Improved predictive models for acute kidney injury with IDEA: intraoperative data embedded analytics. PLOS ONE 14, e0214904 (2019).

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  7. Bihorac, A. et al. MySurgeryRisk: development and validation of a machine-learning risk algorithm for major complications and death after surgery. Ann. Surg. 269, 652–662 (2019).

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  8. Kuo, C.-C. et al. Automation of the kidney function prediction and classification through ultrasound-based kidney imaging using deep learning. NPJ Digit. Med. 2, 29 (2019).

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  9. Hermsen, M. et al. Deep learning-based histopathologic assessment of kidney tissue. J. Am. Soc. Nephrol. 30, 1968–1979 (2019).

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  10. Davoudi, A. et al. Intelligent ICU for autonomous patient monitoring using pervasive sensing and deep learning. Sci. Rep. 9, 8020 (2019).

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Acknowledgements

The authors received research funding from the NIH (R21 EB027344 and R01GM110240 awarded to A.B.; R21 EB027344 and R01GM110240 awarded to P.R.) and the National Science Foundation (Career IIS 1750192 awarded to P.R.).

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Correspondence to Azra Bihorac.

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Competing interests

The University of Florida has two pending patent applications related to some of algorithms published in the highlighted articles: Bihorac, A., Li, X., Rashidi, P., Pardalos, P., Ozrazgat-Baslanti, T., Hogan, W., Wang, D. Z., Momcilovic, P. & Lipori, G. Method and apparatus for prediction of complications after surgery. Appl. No. PCT/IB2018/053956, 1 June 2018, A&B ref. 049648/514983, UF ref.16671; Rashidi, P., Bihorac, A. & Tighe, P. J. Method and apparatus for pervasive patient monitoring. Nonprovisional Appl. No. 16/388,351, 18 April 2019, A&B ref. 049648/529839, UF ref.17317.

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Rashidi, P., Bihorac, A. Artificial intelligence approaches to improve kidney care. Nat Rev Nephrol 16, 71–72 (2020). https://doi.org/10.1038/s41581-019-0243-3

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