Prediction of Hemodialysis Timing Based on LVW Feature Selection and Ensemble Learning

Model for Predicting Complications of Hemodialysis Patients Using Data From the Internet of Medical Things and Electronic Medical Records

Intelligent models for predicting hemodialysis-related complications, i.e., hypotension and the deterioration of the quality or obstruction of the AV fistula, based on machine learning (ML) methods were established to offer early warnings to medical staff and give them enough time to provide pre-emptive treatment. A novel integration platform collected data from the Internet of Medical Things (IoMT) at a dialysis center and inspection results from electronic medical records (EMR) to train ML algorithms and build models. The selection of the feature parameters was implemented using Pearson's correlation method. Then, the eXtreme Gradient Boost (XGBoost) algorithm was chosen to create the predictive models and optimize the feature choice. 75% of collected data are used as a training dataset and the other 25% are used as a testing dataset. We adopted the prediction precision and recall rate of hypotension and AV fistula obstruction to measure the effectiveness of the predictive models. These rates were sufficiently high at approximately 71%-90%. In the context of hemodialysis, hypotension and the deterioration of the quality or obstruction of the arteriovenous (AV) fistula affect treatment quality and patient safety and may lead to a poor prognosis. Our prediction models with high accuracies can provide excellent references and signals for clinical healthcare service providers. Clinical and Translational Impact Statement-With the integrated dataset collected from IoMT and EMR, the superior predictive results of our models for complications of hemodialysis patients are demonstrated. We believe, after enough clinical tests are implemented as planned, these models can assist the healthcare team in making appropriate preparations in advance or adjusting the medical procedures to avoid these adverseevents.

Machine learning models using non-linear techniques improve the prediction of resting energy expenditure in individuals receiving hemodialysis

PURPOSE

Approximately 700,000 people in the USA have chronic kidney disease requiring dialysis. Protein-energy wasting (PEW), a condition of advanced catabolism, contributes to three-year survival rates of 50%. PEW occurs at all levels of Body Mass Index (BMI) but is devastating for those people at the extremes. Treatment for PEW depends on an accurate understanding of energy expenditure. Previous research established that current methods of identifying PEW and assessing adequate treatments are imprecise. This includes disease-specific equations for estimated resting energy expenditure (eREE). In this study, we applied machine learning (ML) modelling techniques to a clinical database of dialysis patients. We assessed the precision of the ML algorithms relative to the best-performing traditional equation, the MHDE.

METHODS

This was a secondary analysis of the Rutgers Nutrition and Kidney Database. To build the ML models we divided the population into test and validation sets. Eleven ML models were run and optimized, with the best three selected by the lowest root mean squared error (RMSE) from measured REE. Values for eREE were generated for each ML model and for the MHDE. We compared precision using Bland-Altman plots.

RESULTS

Individuals were 41.4% female and 82.0% African American. The mean age was 56.4 ± 11.1 years, and the median BMI was 28.8 (IQR = 24.8 - 34.0) kg/m2. The best ML models were SVR, Linear Regression and Elastic net with RMSE of 103.6 kcal, 119.0 kcal and 121.1 kcal respectively. The SVR demonstrated the greatest precision, with 91.2% of values falling within acceptable limits. This compared to 47.1% for the MHDE. The models using non-linear techniques were precise across extremes of BMI.

CONCLUSION

ML improves precision in calculating eREE for dialysis patients, including those most vulnerable for PEW. Further development for clinical use is a priority.

Early prediction of hemodialysis complications employing ensemble techniques

Background and objectives

Hemodialysis complications remain a critical threat among dialysis patients. They result in sudden termination of the session which impacts the efficiency of dialysis. As intra-dialytic complications are the result of the interplay of multiple factors, artificial intelligence can aid in their early prediction. This research aims to compare different machine learning tools for the early prediction of the most frequent hemodialysis complications with high performance, using the fewest predictors for easier practical implementation.

Methods

Fifty different variables were recorded during 6000 hemodialysis sessions performed in a regional dialysis unit in Egypt. The filter technique was used to extract the most relevant features. Then, five individual classifiers and three ensemble approaches were implemented to predict the occurrence of intra-dialytic complications. Different subsets of 25, 12 and 6 from the 50 collected features were tested.

Results

Random forest yielded the highest accuracy of 98% with the least training time using 12 features in a balanced dataset, while the gradient boosting allowed obtaining the highest F1-score of 94%, 92%, and 78% in the prediction of hypotension, hypertension, and dyspnea, respectively, in imbalanced datasets.

Conclusion

Applying different machine learning algorithms to big datasets can improve accuracy, reduce training time and model complexity allowing simple implementation in clinical practice. Our models can help nephrologists predict and possibly prevent dialysis complications.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12938-022-01044-0.

Diagnosis of Chronic Kidney Disease Using Effective Classification Algorithms and Recursive Feature Elimination Techniques

Chronic kidney disease (CKD) is among the top 20 causes of death worldwide and affects approximately 10% of the world adult population. CKD is a disorder that disrupts normal kidney function. Due to the increasing number of people with CKD, effective prediction measures for the early diagnosis of CKD are required. The novelty of this study lies in developing the diagnosis system to detect chronic kidney diseases. This study assists experts in exploring preventive measures for CKD through early diagnosis using machine learning techniques. This study focused on evaluating a dataset collected from 400 patients containing 24 features. The mean and mode statistical analysis methods were used to replace the missing numerical and the nominal values. To choose the most important features, Recursive Feature Elimination (RFE) was applied. Four classification algorithms applied in this study were support vector machine (SVM), k-nearest neighbors (KNN), decision tree, and random forest. All the classification algorithms achieved promising performance. The random forest algorithm outperformed all other applied algorithms, reaching an accuracy, precision, recall, and F1-score of 100% for all measures. CKD is a serious life-threatening disease, with high rates of morbidity and mortality. Therefore, artificial intelligence techniques are of great importance in the early detection of CKD. These techniques are supportive of experts and doctors in early diagnosis to avoid developing kidney failure.