Prediction of Cisplatin‐Induced Acute Kidney Injury Using an Interpretable Machine Learning Model and Electronic Medical Record Information

ABSTRACT Predicting cisplatin‐induced acute kidney injury (Cis‐AKI) before its onset is important. We aimed to develop a predictive model for Cis‐AKI using patient clinical information based on an interpretable machine learning algorithm. This single‐center retrospective study included hospitalized...

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Main Authors: Kaori Ambe, Yuka Aoki, Miho Murashima, Chiharu Wachino, Yuto Deki, Masaya Ieda, Masahiro Kondo, Yoko Furukawa‐Hibi, Kazunori Kimura, Takayuki Hamano, Masahiro Tohkin
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Clinical and Translational Science
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Online Access:https://doi.org/10.1111/cts.70115
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author Kaori Ambe
Yuka Aoki
Miho Murashima
Chiharu Wachino
Yuto Deki
Masaya Ieda
Masahiro Kondo
Yoko Furukawa‐Hibi
Kazunori Kimura
Takayuki Hamano
Masahiro Tohkin
author_facet Kaori Ambe
Yuka Aoki
Miho Murashima
Chiharu Wachino
Yuto Deki
Masaya Ieda
Masahiro Kondo
Yoko Furukawa‐Hibi
Kazunori Kimura
Takayuki Hamano
Masahiro Tohkin
author_sort Kaori Ambe
collection DOAJ
description ABSTRACT Predicting cisplatin‐induced acute kidney injury (Cis‐AKI) before its onset is important. We aimed to develop a predictive model for Cis‐AKI using patient clinical information based on an interpretable machine learning algorithm. This single‐center retrospective study included hospitalized patients aged ≥ 18 years who received the first course of cisplatin chemotherapy from January 1, 2011, to December 31, 2020, at Nagoya City University Hospital. Cis‐AKI‐positive patients were defined using the serum creatinine criteria of the Kidney Disease Improving Global Outcomes guideline within 14 days of the last day of cisplatin administration in the first course. Patients who received cisplatin but did not develop AKI were considered negative. The CatBoost classification model was constructed with 29 explanatory variables, including laboratory values, concomitant medications, medical history, and cisplatin administration information. In total, 1253 patients were included, of whom 119 developed Cis‐AKI (9.5%). The median time of AKI onset was 7 days, and the interquartile range was 5–8 days. The mean ± standard deviation of the total cisplatin dose in the initial treatment was 77.9 ± 27.1 mg/m2 in Cis‐AKI‐positive patients and 69.3 ± 22.6 mg/m2 in Cis‐AKI‐negative patients. The predictive performance was an ROC‐AUC of 0.78. Model interpretation using SHapley Additive exPlanations showed that concomitant use of intravenous magnesium preparations was negatively correlated with Cis‐AKI, whereas loop diuretics were positively correlated. This suggests the need for magnesium preparations to prevent AKI, although the effects of diuretics may be small. Our model can predict Cis‐AKI early and may be helpful for its avoidance.
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spelling doaj-art-394094bc26314727a08f7aca0b824e152025-01-24T08:17:46ZengWileyClinical and Translational Science1752-80541752-80622025-01-01181n/an/a10.1111/cts.70115Prediction of Cisplatin‐Induced Acute Kidney Injury Using an Interpretable Machine Learning Model and Electronic Medical Record InformationKaori Ambe0Yuka Aoki1Miho Murashima2Chiharu Wachino3Yuto Deki4Masaya Ieda5Masahiro Kondo6Yoko Furukawa‐Hibi7Kazunori Kimura8Takayuki Hamano9Masahiro Tohkin10Department of Regulatory Science Nagoya City University Graduate School of Pharmaceutical Sciences Nagoya JapanDepartment of Regulatory Science Nagoya City University Graduate School of Pharmaceutical Sciences Nagoya JapanDepartment of Nephrology Nagoya City University Graduate School of Medical Sciences Nagoya JapanNagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Regulatory Science Nagoya City University Graduate School of Pharmaceutical Sciences Nagoya JapanDepartment of Regulatory Science Nagoya City University Graduate School of Pharmaceutical Sciences Nagoya JapanNagoya City University Graduate School of Medical Sciences Nagoya JapanNagoya City University Graduate School of Medical Sciences Nagoya JapanNagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Nephrology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Regulatory Science Nagoya City University Graduate School of Pharmaceutical Sciences Nagoya JapanABSTRACT Predicting cisplatin‐induced acute kidney injury (Cis‐AKI) before its onset is important. We aimed to develop a predictive model for Cis‐AKI using patient clinical information based on an interpretable machine learning algorithm. This single‐center retrospective study included hospitalized patients aged ≥ 18 years who received the first course of cisplatin chemotherapy from January 1, 2011, to December 31, 2020, at Nagoya City University Hospital. Cis‐AKI‐positive patients were defined using the serum creatinine criteria of the Kidney Disease Improving Global Outcomes guideline within 14 days of the last day of cisplatin administration in the first course. Patients who received cisplatin but did not develop AKI were considered negative. The CatBoost classification model was constructed with 29 explanatory variables, including laboratory values, concomitant medications, medical history, and cisplatin administration information. In total, 1253 patients were included, of whom 119 developed Cis‐AKI (9.5%). The median time of AKI onset was 7 days, and the interquartile range was 5–8 days. The mean ± standard deviation of the total cisplatin dose in the initial treatment was 77.9 ± 27.1 mg/m2 in Cis‐AKI‐positive patients and 69.3 ± 22.6 mg/m2 in Cis‐AKI‐negative patients. The predictive performance was an ROC‐AUC of 0.78. Model interpretation using SHapley Additive exPlanations showed that concomitant use of intravenous magnesium preparations was negatively correlated with Cis‐AKI, whereas loop diuretics were positively correlated. This suggests the need for magnesium preparations to prevent AKI, although the effects of diuretics may be small. Our model can predict Cis‐AKI early and may be helpful for its avoidance.https://doi.org/10.1111/cts.70115acute kidney injurycisplatinelectronic medical recordmachine learning
spellingShingle Kaori Ambe
Yuka Aoki
Miho Murashima
Chiharu Wachino
Yuto Deki
Masaya Ieda
Masahiro Kondo
Yoko Furukawa‐Hibi
Kazunori Kimura
Takayuki Hamano
Masahiro Tohkin
Prediction of Cisplatin‐Induced Acute Kidney Injury Using an Interpretable Machine Learning Model and Electronic Medical Record Information
Clinical and Translational Science
acute kidney injury
cisplatin
electronic medical record
machine learning
title Prediction of Cisplatin‐Induced Acute Kidney Injury Using an Interpretable Machine Learning Model and Electronic Medical Record Information
title_full Prediction of Cisplatin‐Induced Acute Kidney Injury Using an Interpretable Machine Learning Model and Electronic Medical Record Information
title_fullStr Prediction of Cisplatin‐Induced Acute Kidney Injury Using an Interpretable Machine Learning Model and Electronic Medical Record Information
title_full_unstemmed Prediction of Cisplatin‐Induced Acute Kidney Injury Using an Interpretable Machine Learning Model and Electronic Medical Record Information
title_short Prediction of Cisplatin‐Induced Acute Kidney Injury Using an Interpretable Machine Learning Model and Electronic Medical Record Information
title_sort prediction of cisplatin induced acute kidney injury using an interpretable machine learning model and electronic medical record information
topic acute kidney injury
cisplatin
electronic medical record
machine learning
url https://doi.org/10.1111/cts.70115
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