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Machine-learning test may improve kidney failure prediction in patients with diabetes

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For patients with type 2 diabetes or the APOL1-HR genotype, a machine learning test integrating biomarkers and electronic health record data demonstrated improved prediction of kidney failure compared with commonly used clinical models. According to Kinsuk Chauhan, MD, MPH, of Icahn School of Medicine at Mount Sinai, and colleagues, diabetic kidney disease from type 2 diabetes accounts for 44% of all patients with end-stage kidney disease, with the APOL1 high-risk genotypes also associated with increased risk for chronic kidney disease progression and eGFR decline that may ultimately result in kidney failure. "Even though these populations are on average higher risk than the general population, accurate prediction of who will have rapid kidney function decline (RKFD) and worse kidney outcomes is lacking," the researchers wrote, noting that the current standard of using the kidney failure risk equation to predict ESKD has only been validated in patients who already have kidney disease and not in those with preserved kidney function at baseline. "Widespread electronic health records (EHR) usage provides the potential to leverage thousands of clinical features," the researchers added. "Standard statistical approaches are inadequate to leverage this data due to feature volume, unaligned nature of data and correlation structure."