Mid Sweden University

Objective To develop a neural network model for the evaluation of glomerular filtration rate (GFR) based on multilayer perceptual neural network, and to compare with the improved Chinese based creatinine GFR evaluation formula (C - GFRcr) and the evaluation formula (EPI - GFRcr) of the American Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) for the clinical applicability of multilayer perceptual neural network model in evaluating GFR. Methods A total of 684 chronic kidney disease (CKD) patients used for developing a modified version of China′s based creatinine GFR evaluation formula were taken as the research object. The data of 454 patients were randomly selected as the development group and the data of the other 230 patients were as the verification group. The multilayer perceptual neural network GFR evaluation model (M - GFRcr) was established. With the double plasma GFR as the reference value (rGFR), the correlation, mean difference, mean absolute difference, precision and accuracy of C - GFRcr, EPI - GFRcr and M - GFRcr were compared. Results Among the 684 CKD patients, there were 352 males and 332 females, with age of (49.9 ± 15.8) years. The correlation between M - GFRcr and rGFR was the highest (Pearson correlation =0.93, P＜0.001). The mean difference of M - GFRcr was lower than that of C - GFRcr (Z=9.929, P＜0.001) and EPI - GFRcr (Z=10.573, P＜0.001). The mean absolute difference of M - GFRcr was also lower than that of C - GFRcr (Z=3.953, P＜0.001) and EPI - GFRcr (Z=4.210, P＜0.001). The accuracy of ± 15% of M - GFRcr was higher than that of C - GFRcr (χ2=26.068, P＜0.001) and EPI - GFRcr (χ2=23.154, P＜0.001). The accuracy of ±30% of M-GFRcr was also higher than that of C-GFRcr (χ2=8.264, P=0.001) and EPI-GFRcr (χ2=11.963, P=0.001). The results of different stages of CKD showed that in the early stage of CKD (CKD 1-2), the mean difference of M - GFRcr was lower than that of C - GFRcr (Z=7.401, P＜0.001) and EPI - GFRcr (Z=8.096, P ＜ 0.001); the mean absolute difference of M - GFRcr was also lower than that of C - GFRcr (Z=4.723, P＜0.001) and EPI - GFRcr (Z=4.946, P＜0.001); the accuracy of ±15% of M - GFRcr was higher than that of C - GFRcr (χ2=23.547, P＜0.001) and EPI - GFRcr (χ2=26.421, P＜0.001); the accuracy of ± 30% of M - GFRcr was also higher than that of C - GFRcr (χ2=12.089, P=0.001) and EPI - GFRcr (χ2=16.168, P ＜ 0.001). But there was no significant difference in the applicability among C - GFRcr, EPI - GFRcr and M - GFRcr in the advanced stages of CKD (CKD 3-5). Conclusion Compared with the improved Chinese based creatinine GFR evaluation formula C - GFRcr and CKD - EPI evaluation formula EPI - GFRcr, the accuracy of multilayer perceptual neural network model to evaluate GFR in CKD patients has been significantly improved, especially in CKD 1-2 stage.