Artificial intelligence experts and healthcare professionals in Portsmouth have come together to help prevent a common and painful complication in advanced kidney failure treatment.
A study led by the University of Portsmouth and Portsmouth Hospitals University NHS Trust (PHUT) has developed an AI model to predict which patients are most at risk of their blood pressure dropping during dialysis; a condition known as intradialytic hypotension (IDH).
3 million people have Chronic Kidney Disease in the UK and 31,000 of these are on haemodialysis (Kidney Care UK), where their blood is circulated through a machine to clean it of toxins.
One of the most common complications for patients undergoing this treatment at home or in centres is IDH, which occurs when their blood pressure drops suddenly.
It is associated with increased mortality and hospitalisations, and until now there has been no reliable way to predict if it will occur.
Pre-dialysis and real-time data were collected from 10 treatment centres over two decades (2000-2020), involving 3,944 patients. The team used data comprising a total of 73,323 sessions with 36,662 IDH events.
Using this information, they identified 33 variables to determine the most at-risk individuals. These were all observations that are routinely collected during clinical care, such as weight, temperature, age, blood pressure, medication and treatment details.
Machine-learning algorithms were used to build a predictor that could be useful in preventing IDH events from occurring.
The analysis also revealed that systolic and diastolic blood pressures are key predictor variables.
This research highlights the value of using machine learning in healthcare, particularly in complex situations like haemodialysis. Predicting hypotension not only helps clinicians intervene early but also opens the door to personalised care. As we continue to develop and refine these models, the goal is to create a practical decision-support system that could enhance dialysis management, patient safety and quality of careDr Shamsul Masum, University’s School of Electrical and Mechanical Engineering
The study also tested the algorithm using only pre-dialysis data as inputs, to model the scenario at the start of a dialysis session. It found the prediction performance decreased but nevertheless remained clinically useful.
This model offers great promise that could pave the way to a future where AI/ML can be used to personalise treatments for individuals on dialysis and significantly reduce the risk of IDH and other complicationsDr Nicholas Sangala, Consultant Nephrologist
Clinical prediction of IHD is difficult and unreliable. This study indicates that AI and machine learning may be used as a tool to help deliver safer care to patientsRobert Lewis, Consultant Nephrologist
The idea for the model stemmed from a previous study led by the University and the Trust. Two years ago, the team announced the development of an algorithm which can estimate how long a patient might spend in hospital if they’re diagnosed with bowel cancer.
Using artificial intelligence and data analytics, they were able to predict the length of the patient’s hospital stay, whether they would be readmitted after surgery, and their likelihood of death over a one or three-month period.
Although generative AI is grabbing the headlines, these studies show that AI to support decision-making remains just as important, and that machine learning can be effective using existing moderately sized datasetsAdrian Hopgood, Emeritus Professor
Both studies were part of Portsmouth’s Future and Emerging Technologies research theme; one of five thematic areas that are written into the University's Strategy 2025 that support collaboration to extend knowledge and impact in interdisciplinary research, innovation and education.
Newswise/ AJ