Computer Aided Detection System for Prediction of the Malaise during Hemodialysis.

Sabina Tangaro,Giuliana Loizzo,Roberto Corciulo,Deni Aldo Procaccini,Annarita Fanizzi,Lucia Vernò,Roberto Bellotti,Nicola Amoroso,Loreto Gesualdo,Elena Garuccio

doi:10.1155/2016/8748156

Abstract

Monitoring of dialysis sessions is crucial as different stress factors can yield suffering or critical situations. Specialized personnel is usually required for the administration of this medical treatment; nevertheless, subjects whose clinical status can be considered stable require different monitoring strategies when compared with subjects with critical clinical conditions. In this case domiciliary treatment or monitoring can substantially improve the quality of life of patients undergoing dialysis. In this work, we present a Computer Aided Detection (CAD) system for the telemonitoring of patients' clinical parameters. The CAD was mainly designed to predict the insurgence of critical events; it consisted of two Random Forest (RF) classifiers: the first one (RF1) predicting the onset of any malaise one hour after the treatment start and the second one (RF2) again two hours later. The developed system shows an accurate classification performance in terms of both sensitivity and specificity. The specificity in the identification of nonsymptomatic sessions and the sensitivity in the identification of symptomatic sessions for RF2 are equal to 86.60% and 71.40%, respectively, thus suggesting the CAD as an effective tool to support expert nephrologists in telemonitoring the patients.

Highlights

Uremia is likely to occur when a person reaches the final stage of End Stage Renal Disease (ESRD) as in the presence of renal failure, urinary waste products, such as nitrogenous substances and in particular urea, accumulate in the blood
The Computer Aided Detection (CAD) was mainly designed to predict the insurgence of critical events; it consisted of two Random Forest (RF) classifiers: the first one (RF1) predicting the onset of any malaise one hour after the treatment start and the second one (RF2) again two hours later
It is worthwhile to note that today dialysis patients represent only 1% to 2% of the population affected by chronic kidney disease [2]; over the past three decades, the incidence of the ESRD has rapidly grown

Summary

Introduction

Uremia is likely to occur when a person reaches the final stage of End Stage Renal Disease (ESRD) as in the presence of renal failure, urinary waste products, such as nitrogenous substances and in particular urea, accumulate in the blood In these cases hemodialysis is the medical treatment replacing (but not restoring) the kidney function, allowing the extracorporeal removal of free water and waste products from the blood. It is worthwhile to note that today dialysis patients represent only 1% to 2% of the population affected by chronic kidney disease [2]; over the past three decades, the incidence of the ESRD has rapidly grown This “silent epidemic” represents a huge burden on the national healthcare systems. These estimates are going to double its value within the 5 years, not even considering other costs related to additional medical expenses, increased rate of morbidity, hospitalization, reduction in work capability, and life expectancy [4]

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Conclusion