Prediction of hyperkalemia in ESRD patients by identification of multiple leads and multiple features on ECG

Background Patients with end-stage renal disease (ESRD) especially those undergoing dialysis have a high prevalence of hyperkalemia, which must be detected and treated immediately. But the initial symptoms of hyperkalemia are insidious, and traditional laboratory serum potassium concentration testin...

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Main Authors: Daojun Xu, Bin Zhou, Jiaqi Zhang, Chenyu Li, Chen Guan, Yuxuan Liu, Lin Li, Haina Li, Li Cui, Lingyu Xu, Hang Liu, Li Zhen, Yan Xu
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2212800
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_version_ 1850187066707542016
author Daojun Xu
Bin Zhou
Jiaqi Zhang
Chenyu Li
Chen Guan
Yuxuan Liu
Lin Li
Haina Li
Li Cui
Lingyu Xu
Hang Liu
Li Zhen
Yan Xu
author_facet Daojun Xu
Bin Zhou
Jiaqi Zhang
Chenyu Li
Chen Guan
Yuxuan Liu
Lin Li
Haina Li
Li Cui
Lingyu Xu
Hang Liu
Li Zhen
Yan Xu
author_sort Daojun Xu
collection DOAJ
description Background Patients with end-stage renal disease (ESRD) especially those undergoing dialysis have a high prevalence of hyperkalemia, which must be detected and treated immediately. But the initial symptoms of hyperkalemia are insidious, and traditional laboratory serum potassium concentration testing takes time. Therefore, rapid and real-time measurement of serum potassium is urgently needed. In this study, different machine learning methods were used to make rapid predictions of different degrees of hyperkalemia by analyzing the ECG.Methods A total of 1024 datasets of ECG and serum potassium concentrations were analyzed from December 2020 to December 2021. The data were scaled into training and test sets. Different machine learning models (LR, SVM, CNN, XGB, Adaboost) were built for dichotomous prediction of hyperkalemia by analyzing 48 features of chest leads V2-V5. The performance of the models was also evaluated and compared using sensitivity, specificity, accuracy, accuracy, F1 score and AUC.Results We constructed different machine models to predict hyperkalemia using LR and four other common machine-learning methods. The AUCs of the different models ranged from 0.740 (0.661, 0.810) to 0.931 (0.912,0.953) when different serum potassium concentrations were used as the diagnostic threshold for hyperkalemia, respectively. As the diagnostic threshold of hyperkalemia was raised, the sensitivity, specificity, accuracy and precision of the model decreased to various degrees. And AUC also performed less well than when predicting mild hyperkalemia.Conclusion Noninvasive and rapid prediction of hyperkalemia can be achieved by analyzing specific waveforms on the ECG by machine learning methods. But overall, XGB had a higher AUC in mild hyperkalemia, but SVM performed better in predicting more severe hyperkalemia.
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spelling doaj-art-0d96e8f28d7b4e49a7d517925f43a0622025-08-20T02:16:11ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2212800Prediction of hyperkalemia in ESRD patients by identification of multiple leads and multiple features on ECGDaojun Xu0Bin Zhou1Jiaqi Zhang2Chenyu Li3Chen Guan4Yuxuan Liu5Lin Li6Haina Li7Li Cui8Lingyu Xu9Hang Liu10Li Zhen11Yan Xu12Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaDepartment of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaDepartment of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaMedizinische Klinik und Poliklinik IV, Klinikum der Universität, LMU München, München, GermanyDepartment of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaSchool of Artificial Intelligence, Sun Yat-sen University, Guangzhou, P.R. ChinaDepartment of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaDepartment of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaDepartment of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaDepartment of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaDepartment of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaDepartment of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaDepartment of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. ChinaBackground Patients with end-stage renal disease (ESRD) especially those undergoing dialysis have a high prevalence of hyperkalemia, which must be detected and treated immediately. But the initial symptoms of hyperkalemia are insidious, and traditional laboratory serum potassium concentration testing takes time. Therefore, rapid and real-time measurement of serum potassium is urgently needed. In this study, different machine learning methods were used to make rapid predictions of different degrees of hyperkalemia by analyzing the ECG.Methods A total of 1024 datasets of ECG and serum potassium concentrations were analyzed from December 2020 to December 2021. The data were scaled into training and test sets. Different machine learning models (LR, SVM, CNN, XGB, Adaboost) were built for dichotomous prediction of hyperkalemia by analyzing 48 features of chest leads V2-V5. The performance of the models was also evaluated and compared using sensitivity, specificity, accuracy, accuracy, F1 score and AUC.Results We constructed different machine models to predict hyperkalemia using LR and four other common machine-learning methods. The AUCs of the different models ranged from 0.740 (0.661, 0.810) to 0.931 (0.912,0.953) when different serum potassium concentrations were used as the diagnostic threshold for hyperkalemia, respectively. As the diagnostic threshold of hyperkalemia was raised, the sensitivity, specificity, accuracy and precision of the model decreased to various degrees. And AUC also performed less well than when predicting mild hyperkalemia.Conclusion Noninvasive and rapid prediction of hyperkalemia can be achieved by analyzing specific waveforms on the ECG by machine learning methods. But overall, XGB had a higher AUC in mild hyperkalemia, but SVM performed better in predicting more severe hyperkalemia.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2212800Electrocardiogramnoninvasive hyperkalemia predictionend-stage renal diseasemachine learninglogistic regression
spellingShingle Daojun Xu
Bin Zhou
Jiaqi Zhang
Chenyu Li
Chen Guan
Yuxuan Liu
Lin Li
Haina Li
Li Cui
Lingyu Xu
Hang Liu
Li Zhen
Yan Xu
Prediction of hyperkalemia in ESRD patients by identification of multiple leads and multiple features on ECG
Renal Failure
Electrocardiogram
noninvasive hyperkalemia prediction
end-stage renal disease
machine learning
logistic regression
title Prediction of hyperkalemia in ESRD patients by identification of multiple leads and multiple features on ECG
title_full Prediction of hyperkalemia in ESRD patients by identification of multiple leads and multiple features on ECG
title_fullStr Prediction of hyperkalemia in ESRD patients by identification of multiple leads and multiple features on ECG
title_full_unstemmed Prediction of hyperkalemia in ESRD patients by identification of multiple leads and multiple features on ECG
title_short Prediction of hyperkalemia in ESRD patients by identification of multiple leads and multiple features on ECG
title_sort prediction of hyperkalemia in esrd patients by identification of multiple leads and multiple features on ecg
topic Electrocardiogram
noninvasive hyperkalemia prediction
end-stage renal disease
machine learning
logistic regression
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2212800
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