Evidence mapPaperPMID 42381983Full record

ArticleResearch (Washington, D.C.)2026

Predicting 1-Year Renal Outcomes in Patients with Diabetic Kidney Disease in CKD Stages 3 to 4: A Multimodal Machine Learning Approach Fusing Clinical Composites and Pathology Images.

Xiangmeng Li, Jinyu Liu, Erjina Huo, Peihua Zhang, Shimin Jiang, Cheng Zhou, Shunlai Shang, Wenge Li

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Article in Research (Washington, D.C.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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8 authors.

Xiangmeng LiDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, China.
Jinyu LiuDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, China.ORCID https://orcid.org/0009-0000-2991-8315
Erjina HuoUniversity of Bristol, Bristol, UK.
Peihua ZhangSchool of Big Data Science, Hebei Finance University, Baoding, Hebei, China.
Shimin JiangDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, China.
Cheng ZhouDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, China.
Shunlai ShangDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, China.
Wenge LiDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients with diabetic kidney disease (DKD) at chronic kidney disease (CKD) stages 3 to 4 are at high risk for rapid renal function decline within 1 year. However, owing to the multifactorial complexity of the disease, effective prognostic tools that integrate multidimensional clinical and pathological information are currently lacking for this specific population. We conducted a retrospective cohort study involving 322 patients with biopsy-proven DKD (CKD stages 3 to 4) from the China-Japan Friendship Hospital and Hebei University Affiliated Hospital. Their clinical data and 2,576 renal biopsy pathology images were used to develop and validate a multimodal model. Machine learning was applied to integrate clinical composite indices and renal biopsy images to develop a prognostic prediction tool. Four key clinical predictors were identified: estimated glomerular filtration rate, 24-h urinary protein, systemic immune inflammation index, and estimated pulse wave velocity. Among the 6 machine learning algorithms used to develop the prediction models, the random forest algorithm achieved the best performance in the test set, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.889 and a precision-recall AUC (PR-AUC) of 0.921 for predicting the 1-year composite renal endpoint. The integration of pathological features led to a marked improvement in the performance of the model (ROC-AUC: 0.923 vs. 0.898). External validation demonstrated that incorporating pathological information into the model increased the ROC-AUC from 0.885-achieved when clinical composite indices alone were used as predictors-to 0.930. In this study, machine learning-based automated image analysis of glomerular crescent-shaped changes and renal interstitial fibrosis was integrated with established clinical composite indices to construct an accurate model for predicting short-term renal prognosis of DKD at CKD stages 3 to 4 and to provide a potential tool for improved risk stratification.

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PMID42381983
PMCPMC13315329

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.