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Abstract: TH-PO867

New Surrogate Marker of CKD Progression and Mortality in Medical Word Virtual Space: Prospective Cohort Study

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Kanda, Eiichiro, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan
  • Epureanu, Bogdan I., University of Michigan, Ann Arbor, Michigan, United States
  • Adachi, Taiji, Kyoto Daigaku, Kyoto, Japan
  • Kashihara, Naoki, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan
Background

Chronic kidney disease (CKD) leads to end-stage renal disease (ESRD) or death. A new surrogate marker reflecting its pathophysiology has been needed for CKD therapy.

Methods

In this study, we developed a virtual space unifying data in the medical literature and that of actual CKD patients and created a surrogate marker of CKD progression and mortality using natural language processing.

Results

A virtual space of medical words was constructed from the CKD-related literature (n=165,271) using natural language processing, in which CKD-related words (n=106,612) composed a network (Figure 1). The data of CKD patients of a prospective cohort study for three years (n=26,433) were transformed into the space and linked with the network on the basis of information-geometry theory. We let the relationship between a patient and the outcome (ESRD or death) in the network be a surrogate marker of the outcome. The network satisfied the definitions of vector keeping their medical meanings. Riemannian metrics highly accurately predicted the primary outcomes; C-statistics, 0.911. Cox proportional hazards models with spline showed that the high Riemannian metrics were associated with high hazard ratio of the primary outcomes (p<0.0001). Moreover, the risk of the primary outcome in high-Riemannian-metric group was 21.92 (95% CI: 14.77, 32.51) times higher than that in the low-Riemannian-metric group.

Conclusion

The medical-word virtual space reflects the real-world patient data. And the Riemannian metrics between a patient and the outcome is a new surrogate marker for CKD therapy.