Development of an Artificial Intelligence Model to Guide the Management of Blood Pressure, Fluid Volume, and Dialysis Dose in End-Stage Kidney Disease Patients: Proof of Concept and First Clinical Assessment

Kidney Diseases
Carlo BarbieriStefano Stuard

Abstract

Fluid volume and blood pressure (BP) management are crucial endpoints for end-stage kidney disease patients. BP control in clinical practice mainly relies on reducing extracellular fluid volume overload by diminishing targeted postdialysis weight. This approach exposes dialysis patients to intradialytic hypotensive episodes. Both chronic hypertension and intradialytic hypotension lead to adverse long-term outcomes. Achieving the optimal trade-off between adequate fluid removal and the risk of intradialytic adverse events is a complex task in clinical practice given the multiple patient-related and dialysis-related factors affecting the hemodynamic response to treatment. State-of-the-art artificial intelligence has been adopted in other complex decision-making tasks for dialysis patients and may help personalize the multiple dialysis-related prescriptions affecting patients' intradialytic hemodynamics. As a proof of concept, we developed a multiple-endpoint model predicting session-specific Kt/V, fluid volume removal, heart rate, and BP based on patient characteristics, historic hemodynamic responses, and dialysis-related prescriptions. The accuracy and precision of this preliminary model is extremely encouraging. Such analytic ...Continue Reading

References

Sep 1, 1995·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M M Salem
Mar 1, 1997·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·C ZoccaliV Panuccio
Sep 12, 2003·The American Journal of Medicine·Rajiv AgarwalDavid G Warnock
Jul 16, 2016·Kidney International·Michael E Brier, Adam E Gaweda
Apr 27, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jason A ChouKamyar Kalantar-Zadeh

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Citations

Mar 13, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Bernard CanaudFrank Maddux
Mar 13, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jule PinterBernard Canaud
Mar 13, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jeroen P KoomanPeter Kotanko
Sep 6, 2020·Current Opinion in Nephrology and Hypertension·Emily J See, Kevan R Polkinghorne
Oct 30, 2019·Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia·Bernard CanaudAllan Collins
Nov 8, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Alexandru BurlacuAdrian Covic
Jul 1, 2020·BioMed Research International·Alexandru BurlacuAdrian Covic
Nov 10, 2020·KI Reports·Bernard CanaudPeter Kotanko
Feb 13, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Hojun LeeSeung Seok Han
Jul 31, 2021·Scientific Reports·Hyung Woo KimBeom Seok Kim
Aug 31, 2021·Current Opinion in Nephrology and Hypertension·Paul Stewart, Jill Stewart
Mar 1, 2019·Kidney Diseases·Miguel Hueso, Alfredo Vellido

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