한빛사논문
- 조회549
Young Su Joo1,2,10, Tyler Hyungtaek Rim3,4,5,10, Hee Byung Koh1,6, Joseph Yi7, Hyeonmin Kim3, Geunyoung Lee3, Young Ah Kim8, Shin-Wook Kang1, Sung Soo Kim9 and Jung Tak Park1
1Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea.
2Division of Nephrology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
3Mediwhale Inc, Seoul, Republic of Korea.
4Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
5Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore.
6Department of Internal Medicine, International Saint Mary’s Hospital, Catholic Kwandong University, Incheon, Republic of Korea.
7Albert Einstein College of Medicine, New York, USA.
8Division of Digital Health, Yonsei University Health System, Seoul, Republic of Korea.
9Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
10These authors contributed equally: Young Su Joo, Tyler Hyungtaek Rim.
Corresponding authors : Correspondence to Tyler Hyungtaek Rim or Jung Tak Park.
Abstract
Despite the importance of preventing chronic kidney disease (CKD), predicting high-risk patients who require active intervention is challenging, especially in people with preserved kidney function. In this study, a predictive risk score for CKD (Reti-CKD score) was derived from a deep learning algorithm using retinal photographs. The performance of the Reti-CKD score was verified using two longitudinal cohorts of the UK Biobank and Korean Diabetic Cohort. Validation was done in people with preserved kidney function, excluding individuals with eGFR <90 mL/min/1.73 m2 or proteinuria at baseline. In the UK Biobank, 720/30,477 (2.4%) participants had CKD events during the 10.8-year follow-up period. In the Korean Diabetic Cohort, 206/5014 (4.1%) had CKD events during the 6.1-year follow-up period. When the validation cohorts were divided into quartiles of Reti-CKD score, the hazard ratios for CKD development were 3.68 (95% Confidence Interval [CI], 2.88–4.41) in the UK Biobank and 9.36 (5.26–16.67) in the Korean Diabetic Cohort in the highest quartile compared to the lowest. The Reti-CKD score, compared to eGFR based methods, showed a superior concordance index for predicting CKD incidence, with a delta of 0.020 (95% CI, 0.011–0.029) in the UK Biobank and 0.024 (95% CI, 0.002–0.046) in the Korean Diabetic Cohort. In people with preserved kidney function, the Reti-CKD score effectively stratifies future CKD risk with greater performance than conventional eGFR-based methods.
논문정보
- Research article
- 2023년 06월 (BRIC 등록일 2023-06-22)
- 국내(교신)+국외 연구진
- 의약학 > 응용의학
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