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Sci Rep. 2021;11(1):15704.

Machine learning-based prediction of acute kidney injury after nephrectomy in patients with renal cell carcinoma.

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제1저자 이연희 · 교신저자 곽철, 김세중, 한승석

소속 (10)
  1. Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehakro, Jongno-gu, Seoul, 03080, South Korea.
  2. Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu-si, Gyeonggi-do, South Korea.
  3. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
  4. Medical Research Collaborating Center, Seoul National University Hospital, Seoul, South Korea.
  5. Department of Urology, Seoul National University College of Medicine, Seoul, South Korea.
  6. Department of Urology, Seoul National University College of Medicine, Seoul, South Korea. mdrafael@snu.ac.kr.
  7. Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehakro, Jongno-gu, Seoul, 03080, South Korea. sejoong2@snu.ac.kr.
  8. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea. sejoong2@snu.ac.kr.
  9. Center for Artificial Intelligence in Healthcare, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea. sejoong2@snu.ac.kr.
  10. Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehakro, Jongno-gu, Seoul, 03080, South Korea. hansway80@gmail.com.

Abstract

The precise prediction of acute kidney injury (AKI) after nephrectomy for renal cell carcinoma (RCC) is an important issue because of its relationship with subsequent kidney dysfunction and high mortality. Herein we addressed whether machine learning (ML) algorithms could predict postoperative AKI risk better than conventional logistic regression (LR) models. A total of 4104 RCC patients who had undergone unilateral nephrectomy from January 2003 to December 2017 were reviewed. ML models such as support vector machine, random forest, extreme gradient boosting, and light gradient boosting machine (LightGBM) were developed, and their performance based on the area under the receiver operating characteristic curve, accuracy, and F1 score was compared with that of the LR-based scoring model. Postoperative AKI developed in 1167 patients (28.4%). All the ML models had higher performance index values than the LR-based scoring model. Among them, the LightGBM model had the highest value of 0.810 (0.783-0.837). The decision curve analysis demonstrated a greater net benefit of the ML models than the LR-based scoring model over all the ranges of threshold probabilities. The application of ML algorithms improves the predictability of AKI after nephrectomy for RCC, and these models perform better than conventional LR-based models.

© 2021. The Author(s).

Figures

Figure 1
Figure 1 Receiver operating characteristic curves of the reference and machine learning models for predicting acute kidney injury after nephrectomy. LightGBM light gradient boosting machine, XGBoost extreme gradient boosting, SVM support vector machine, RF random forest, LR logistic regression, SPARK simple postoperative acute kidney injury risk.
Figure 2
Figure 2 Decision curve analysis. LightGBM light gradient boosting machine, SVM support vector machine, RF random forest, LR logistic regression, SPARK simple postoperative acute kidney injury risk.
Figure 3
Figure 3 Calibration plots of the light gradient boosting machine (A), extreme gradient boosting (B), support vector machine (C), random forest (D), logistic regression-scoring (E), and simple postoperative acute kidney injury risk (F) models. P values more than 0.05 indicate good calibration.
Figure 4
Figure 4 Importance of each variable in developing models such as light gradient boosting machine (A), extreme gradient boosting (B), and random forest (C) models. eGFR estimated glomerular filtration rate.

그림 출처: PubMed Central 공개 논문 (PMC8333365)

Conflict of interest statement

The authors declare no competing interests.

그 밖의 정보
출판 형태
Journal Article, Research Support, Non-U.S. Gov't
저널
Scientific reports · eISSN 2045-2322
전자 출판
2021-08-03
MeSH
Acute Kidney Injury / diagnosis / etiology · Adult · Aged · Algorithms · Carcinoma, Renal Cell / complications / surgery · Decision Making, Computer-Assisted · Female · Humans · Kidney Neoplasms / complications / surgery · Logistic Models · Machine Learning* · Male · Middle Aged · Nephrectomy / adverse effects · Postoperative Complications* · Prognosis · ROC Curve · Risk Assessment · Support Vector Machine
참고문헌
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