An Equation Based on Fuzzy Mathematics to Assess the Timing of Haemodialysis Initiation.

Journal: Scientific reports
Published Date: Apr 10, 2019

Abstract

In order to develop an equation that integrates multiple clinical factors including signs and symptoms associated with uraemia to assess the initiation of dialysis, we conducted a retrospective cohort study including 25 haemodialysis centres in Mainland China. Patients with ESRD (n = 1281) who commenced haemodialysis from 2008 to 2011 were enrolled in the development cohort, whereas 504 patients who began haemodialysis between 2012 and 2013 were enrolled in the validation cohort comprised. An artificial neural network model was used to select variables, and a fuzzy neural network model was then constructed using factors affecting haemodialysis initiation as input variables and 3-year survival as the output variable. A logistic model was set up using the same variables. The equation's performance was compared with that of the logistic model and conventional eGFR-based assessment. The area under the bootstrap-corrected receiver-operating characteristic curve of the equation was 0.70, and that of two conventional eGFR-based assessments were 0.57 and 0.54. In conclusion, the new equation based on Fuzzy mathematics, covering laboratory and clinical variables, is more suitable for assessing the timing of dialysis initiation in a Chinese ESRD population than eGFR, and may be a helpful tool to quantitatively evaluate the initiation of haemodialysis.

Authors

  • Ying Liu
    The First School of Clinical Medicine, Lanzhou University, Lanzhou, China.
  • Degang Wang
    School of Control Science and Engineering, Dalian University of Technology, Dalian, China.
  • Xiangmei Chen
    Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China.
  • Xuefeng Sun
    Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China.
  • Wenyan Song
    School of Economics, Dongbei University of Finance and Economics, Dalian, China.
  • Hongli Jiang
    Blood Purification Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Wei Shi
    Department of Orthopedics, Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen, China.
  • Wenhu Liu
    Division of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
  • Ping Fu
    Department of Automatic Test and Control, Harbin Institute of Technology, Harbin 150080, China.
  • Xiaoqiang Ding
    Division of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.
  • Ming Chang
    Division of Nephrology, Dalian Municipal Central Hospital, Dalian, China.
  • Xueqing Yu
    Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Ning Cao
    Blood Purification Center, General Hospital of Shenyang Military Area Command, Shenyang, China.
  • Menghua Chen
    Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, China.
  • Zhaohui Ni
    Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
  • Jing Cheng
    Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
  • Shiren Sun
    Department of Nephrology, Xijing Hospital, the Fourth Military Medical University, Xi'an, China.
  • Huimin Wang
    Department of Microbiology, College of Life Science, Key Laboratory for Agriculture Microbiology, Shandong Agricultural University, Taian 271018, China.
  • Yunyan Wang
    School of Metallurgy and Environment, Central South University, Changsha, 410083, China; Chinese National Engineering Research Center for Control & Treatment of Heavy Metal Pollution, Changsha, 410083, China.
  • Bihu Gao
    Division of Nephrology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
  • Jianqin Wang
    Division of Nephrology, Lanzhou University Second Hospital, Lanzhou, China.
  • Lirong Hao
    Division of Nephrology, the First Affiliated Hospital of Harbin Medical University, Harbin, China.
  • Suhua Li
    Division of Nephrology, the First Affiliated Hospital of Xinjiang Medical University, Urumchi, China.
  • Qiang He
    College of Biomass Science and Engineering, Healthy Food Evaluation Research Center, Sichuan University, Chengdu 610065, China.
  • Hongmei Liu
    Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
  • Fengmin Shao
    Blood Purification Center, The People's Hospital of Zhengzhou University & Henan Provincial People's Hospital, Zhengzhou, China.
  • Wei Li
    Department of Nephrology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
  • Yang Wang
    Department of General Surgery The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology Kunming China.
  • Lynda Szczech
    FibroGen, Inc, San Francisco, CA, USA.
  • Qiuxia Lv
    School of Control Science and Engineering, Dalian University of Technology, Dalian, China.
  • Xianfeng Han
    Dalian Medical University Graduate School, Dalian, China.
  • Luping Wang
    Laboratory of Cognitive Model and Algorithm, Department of Computer Science, Fudan University, No. 825 Zhangheng Road, Shanghai 201203, China. 15110240007@fudan.edu.cn.
  • Ming Fang
    Dalian Medical University Graduate School, Dalian, China.
  • Zach Odeh
    Dalian Medical University Graduate School, Dalian, China.
  • Ximing Sun
    School of Control Science and Engineering, Dalian University of Technology, Dalian, China.
  • Hongli Lin
    Dalian Medical University Graduate School, Dalian, China. hllin@dlmedu.edu.cn.

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