人工智能和机器学习在败血症相关急性肾损伤中的作用。

IF 2.9 3区 医学 Q1 UROLOGY & NEPHROLOGY Kidney Research and Clinical Practice Pub Date : 2024-07-01 Epub Date: 2024-06-20 DOI:10.23876/j.krcp.23.298
Wisit Cheungpasitporn, Charat Thongprayoon, Kianoush B Kashani
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引用次数: 0

摘要

脓毒症相关急性肾损伤(SA-AKI)是危重病人的一种严重并发症,可导致更高的死亡率、发病率和费用。SA-AKI 的病理生理学错综复杂,需要警惕的临床监测和适当、及时的干预。虽然传统的统计分析已经确定了 SA-AKI 的严重风险因素,但不同研究的结果并不一致。因此,人们越来越关注利用人工智能(AI)和机器学习(ML)来更好地预测 SA-AKI。通过分析庞大的数据集,机器学习可以发现人类无法识别的复杂模式。事实证明,XGBoost 和 RNN-LSTM 等监督学习模型在预测 SA-AKI 发病和随后的死亡率方面非常准确,往往超过传统的风险评分。同时,无监督学习能揭示不同 SA-AKI 患者中与临床相关的亚型,从而提供更有针对性的治疗。此外,它还能根据患者的预后不断改进脓毒症治疗,从而优化治疗,预防 SA-AKI。然而,利用人工智能/移动医疗在数据隐私、算法偏差和监管合规方面存在伦理和实际挑战。人工智能/ML 可以实现早期风险检测、个性化管理、最佳治疗策略以及 SA-AKI 管理的协作学习。未来的发展方向包括对患者进行实时监测、模拟数据生成和及时干预的预测算法。然而,要顺利过渡到临床实践,需要不断改进模型和严格的监管监督。在本文中,我们概述了用于治疗 SA-AKI 的传统方法,并探讨了如何将人工智能和 ML 应用于诊断和管理 SA-AKI,强调了它们彻底改变 SA-AKI 治疗的潜力。
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Artificial intelligence and machine learning's role in sepsis-associated acute kidney injury.

Sepsis-associated acute kidney injury (SA-AKI) is a serious complication in critically ill patients, resulting in higher mortality, morbidity, and cost. The intricate pathophysiology of SA-AKI requires vigilant clinical monitoring and appropriate, prompt intervention. While traditional statistical analyses have identified severe risk factors for SA-AKI, the results have been inconsistent across studies. This has led to growing interest in leveraging artificial intelligence (AI) and machine learning (ML) to predict SA-AKI better. ML can uncover complex patterns beyond human discernment by analyzing vast datasets. Supervised learning models like XGBoost and RNN-LSTM have proven remarkably accurate at predicting SA-AKI onset and subsequent mortality, often surpassing traditional risk scores. Meanwhile, unsupervised learning reveals clinically relevant sub-phenotypes among diverse SA-AKI patients, enabling more tailored care. In addition, it potentially optimizes sepsis treatment to prevent SA-AKI through continual refinement based on patient outcomes. However, utilizing AI/ML presents ethical and practical challenges regarding data privacy, algorithmic biases, and regulatory compliance. AI/ML allows early risk detection, personalized management, optimal treatment strategies, and collaborative learning for SA-AKI management. Future directions include real-time patient monitoring, simulated data generation, and predictive algorithms for timely interventions. However, a smooth transition to clinical practice demands continuous model enhancements and rigorous regulatory oversight. In this article, we outlined the conventional methods used to address SA-AKI and explore how AI and ML can be applied to diagnose and manage SA-AKI, highlighting their potential to revolutionize SA-AKI care.

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来源期刊
CiteScore
4.60
自引率
10.00%
发文量
77
审稿时长
10 weeks
期刊介绍: Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.
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