Department of Interventional Cardiology-Cardiovascular Diseases Institute, Iasi, Romania.
"Grigore T. Popa" University of Medicine, Iasi, Romania.
Biomed Res Int. 2020 Jun 10;2020:9867872. doi: 10.1155/2020/9867872. eCollection 2020.
The purpose of this review is to depict current research and impact of artificial intelligence/machine learning (AI/ML) algorithms on dialysis and kidney transplantation. Published studies were presented from two points of view: What medical aspects were covered? What AI/ML algorithms have been used?
We searched four electronic databases or studies that used AI/ML in hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT). Sixty-nine studies were split into three categories: AI/ML and HD, PD, and KT, respectively. We identified 43 trials in the first group, 8 in the second, and 18 in the third. Then, studies were classified according to the type of algorithm.
AI and HD trials covered: (a) dialysis service management, (b) dialysis procedure, (c) anemia management, (d) hormonal/dietary issues, and (e) arteriovenous fistula assessment. PD studies were divided into (a) peritoneal technique issues, (b) infections, and (c) cardiovascular event prediction. AI in transplantation studies were allocated into (a) management systems (ML used as pretransplant organ-matching tools), (b) predicting graft rejection, (c) tacrolimus therapy modulation, and (d) dietary issues.
Although guidelines are reluctant to recommend AI implementation in daily practice, there is plenty of evidence that AI/ML algorithms can predict better than nephrologists: volumes, Kt/V, and hypotension or cardiovascular events during dialysis. Altogether, these trials report a robust impact of AI/ML on quality of life and survival in G5D/T patients. In the coming years, one would probably witness the emergence of AI/ML devices that facilitate the management of dialysis patients, thus increasing the quality of life and survival.
本综述旨在描绘人工智能/机器学习(AI/ML)算法在透析和肾移植方面的研究现状和影响。从两个角度呈现已发表的研究:涵盖了哪些医学方面?使用了哪些 AI/ML 算法?
我们检索了四个电子数据库或研究,这些研究使用了人工智能/机器学习在血液透析(HD)、腹膜透析(PD)和肾移植(KT)方面。将 69 项研究分为三组:分别为 AI/ML 和 HD、PD 和 KT。我们在第一组中发现了 43 项试验,第二组 8 项,第三组 18 项。然后,根据算法类型对研究进行分类。
AI 和 HD 试验涵盖:(a)透析服务管理,(b)透析程序,(c)贫血管理,(d)激素/饮食问题,以及(e)动静脉瘘评估。PD 研究分为:(a)腹膜技术问题,(b)感染,以及(c)心血管事件预测。移植研究中的 AI 被分配到:(a)管理系统(ML 用作移植前器官匹配工具),(b)预测移植物排斥,(c)他克莫司治疗调制,以及(d)饮食问题。
尽管指南不愿推荐将 AI 应用于日常实践,但有大量证据表明 AI/ML 算法可以比肾病学家更好地预测:透析期间的体积、Kt/V 和低血压或心血管事件。总的来说,这些试验报告了 AI/ML 对 G5D/T 患者生活质量和生存率的显著影响。在未来几年,人们可能会看到 AI/ML 设备的出现,这些设备将有助于管理透析患者,从而提高生活质量和生存率。