Personalized prediction model generated with machine learning for kidney function one year after living kidney donation.

Journal: Scientific reports
Published Date:

Abstract

Living kidney donors typically experience approximately a 30% reduction in kidney function after donation, although the degree of reduction varies among individuals. This study aimed to develop a machine learning (ML) model to predict serum creatinine (Cre) levels at one year post-donation using preoperative clinical data, including kidney-, fat-, and muscle-volumetry values from computed tomography. A total of 204 living kidney donors were included. Symbolic regression via genetic programming was employed to create an ML-based Cre prediction model using preoperative clinical variables. Validation was conducted using a 7:3 training-to-test data split. The ML model demonstrated a median absolute error of 0.079 mg/dL for predicting Cre. In the validation cohort, it outperformed conventional methods (which assume post-donation eGFR to be 70% of the preoperative value) with higher R (0.58 vs. 0.27), lower root mean squared error (5.27 vs. 6.89), and lower mean absolute error (3.92 vs. 5.8). Key predictive variables included preoperative Cre and remnant kidney volume. The model was deployed as a web application for clinical use. The ML model offers accurate predictions of post-donation kidney function and may assist in monitoring donor outcomes, enhancing personalized care after kidney donation.

Authors

  • Rikako Oki
    Department of Organ Transplant Medicine, Tokyo Women's Medical University, Shinjuku City, Tokyo, Japan.
  • Toshihio Hirai
    Department of Urology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
  • Kazuhiro Iwadoh
    Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
  • Yu Kijima
    Department of Urology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
  • Hiroyuki Hashimoto
    Department of Radiation Oncology, Tokyo Women's Medical University, Shinjuku City, Tokyo, Japan.
  • Yasunori Nishimura
    Department of Radiation Oncology, Tokyo Women's Medical University, Shinjuku City, Tokyo, Japan.
  • Taro Banno
    Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan.
  • Kohei Unagami
    Department of Organ Transplant Medicine, Tokyo Women's Medical University, Shinjuku City, Tokyo, Japan.
  • Kazuya Omoto
    Department of Urology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
  • Tomokazu Shimizu
    Department of Organ Transplant Medicine, Tokyo Women's Medical University, Shinjuku City, Tokyo, Japan.
  • Junichi Hoshino
    Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
  • Toshio Takagi
    Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.
  • Hideki Ishida
    Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.
  • Toshihito Hirai
    Department of Urology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan. hirai.toshihito@twmu.ac.jp.