1. Non-invasive chronic kidney disease risk stratification tool derived from retina-based deep learning and clinical factors.
- Author
-
Joo, Young Su, Rim, Tyler Hyungtaek, Koh, Hee Byung, Yi, Joseph, Kim, Hyeonmin, Lee, Geunyoung, Kim, Young Ah, Kang, Shin-Wook, Kim, Sung Soo, and Park, Jung Tak
- Subjects
CHRONIC kidney failure ,DEEP learning ,EXPERIMENTAL design ,RETINA ,PREDICTIVE tests ,TISSUE banks ,RESEARCH methodology ,RESEARCH methodology evaluation ,RISK assessment ,PHOTOGRAPHY ,DESCRIPTIVE statistics ,SURVIVAL analysis (Biometry) ,KAPLAN-Meier estimator ,DATA analysis software ,ALGORITHMS ,PROPORTIONAL hazards models ,DISEASE risk factors - Abstract
Despite the importance of preventing chronic kidney disease (CKD), predicting high-risk patients who require active intervention is challenging, especially in people with preserved kidney function. In this study, a predictive risk score for CKD (Reti-CKD score) was derived from a deep learning algorithm using retinal photographs. The performance of the Reti-CKD score was verified using two longitudinal cohorts of the UK Biobank and Korean Diabetic Cohort. Validation was done in people with preserved kidney function, excluding individuals with eGFR <90 mL/min/1.73 m
2 or proteinuria at baseline. In the UK Biobank, 720/30,477 (2.4%) participants had CKD events during the 10.8-year follow-up period. In the Korean Diabetic Cohort, 206/5014 (4.1%) had CKD events during the 6.1-year follow-up period. When the validation cohorts were divided into quartiles of Reti-CKD score, the hazard ratios for CKD development were 3.68 (95% Confidence Interval [CI], 2.88–4.41) in the UK Biobank and 9.36 (5.26–16.67) in the Korean Diabetic Cohort in the highest quartile compared to the lowest. The Reti-CKD score, compared to eGFR based methods, showed a superior concordance index for predicting CKD incidence, with a delta of 0.020 (95% CI, 0.011–0.029) in the UK Biobank and 0.024 (95% CI, 0.002–0.046) in the Korean Diabetic Cohort. In people with preserved kidney function, the Reti-CKD score effectively stratifies future CKD risk with greater performance than conventional eGFR-based methods. [ABSTRACT FROM AUTHOR]- Published
- 2023
- Full Text
- View/download PDF