A rule extraction approach to explore the upper limit of hemoglobin during anemia treatment in patients with predialysis chronic kidney disease

In patients with predialysis chronic kidney disease (CKD) and anemia, maintaining appropriate hemoglobin (Hb) levels during treatment for renal anemia is critical. The risk of cardiovascular events increases when target Hb levels are ≥13 g/dL. However, few studies have extensively assessed the upper limit of Hb levels in renal anemia clinics. Therefore, considering the importance of variations in Hb levels, the aim of the present study was to explore the upper limit of Hb levels during anemia treatment in predialysis CKD patients utilizing rule extraction. Data were obtained from the University of California–Irvine Machine Learning Repository. Patients with >2.0 mg/dL of serum creatinine were excluded from the analysis. The remaining 243 patients were classified into either a predialysis CKD group (n = 100) or a non-predialysis CKD (stages 1 and 2) group (n = 143). We explored the upper limit of Hb levels during anemia treatment in predialysis CKD patients utilizing rule extraction. The Recursive-Rule eXtraction (Re-RX) algorithm with J48graft was used to extract the classification rules. Three concrete and concise derived rules were used for anemia treatment. Re-RX with J48graft showed very high classification accuracy (95.18%) for the test dataset and a larger area under the receiver operating characteristic curve (94.4%) using 10 runs of 5-fold cross-validation. We also found an upper-limit Hb level of 12.9 g/dL during anemia treatment utilizing rule extraction to help avoid the risk of cardiovascular events. To the best of our knowledge, this is the first study using rule extraction to explore the upper-limit Hb level to maintain during renal anemia treatment.

Abstract licence: CC BY-NC-ND

1. 29.

   Deep learning · 2015

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