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Abstract: SA-PO0555

Artificial Intelligence in ADPKD: Transforming Diagnosis, Risk Stratification, and Therapeutic Interventions

Session Information

Category: Genetic Diseases of the Kidneys

  • 1201 Genetic Diseases of the Kidneys: Monogenic Kidney Diseases

Authors

  • Ebrahimi, Niloufar, Loma Linda University Medical Center, Loma Linda, California, United States
  • Cheungpasitporn, Wisit, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Abdi Pour, Amir, Loma Linda University Medical Center, Loma Linda, California, United States
Background

Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic kidney disorder, leading to progressive cyst formation and kidney failure. Conventional monitoring primarily relies on imaging and eGFR trends, which may lack sensitivity in detecting early disease progression. Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), offers transformative potential in redefining diagnosis, risk stratification, and treatment optimization in ADPKD.

Methods

A systematic review of all PubMed-indexed literature from inception to 2025 was conducted using search terms related to AI and ADPKD. Peer-reviewed publications were evaluated based on clinical relevance, AI methodologies, validation strategies, and potential clinical impact. Inclusion criteria encompassed studies with robust validation datasets, defined outcome measures, and clinical applicability. AI applications were categorized into diagnostic, prognostic, and therapeutic domains, with a focus on emerging models and their clinical implications.

Results

AI-enabled tools, particularly DL models such as U-Net and convolutional neural networks (CNNs), have demonstrated high performance in automating total kidney volume (TKV) segmentation, reducing interpretation time and inter-reader variability. ML models integrating imaging, genetic, and clinical data outperform current prognostic scores (e.g., MIC, PROPKD) in predicting eGFR decline. AI also facilitates drug repurposing, genotype-phenotype correlation, remote monitoring, and clinical trial optimization. A summary of validated AI models is provided in Table 1.

Conclusion

AI offers transformative potential in ADPKD care by improving diagnostic accuracy, predicting disease progression, and enabling precision nephrology. Future directions include multi-omics integration, real-time remote monitoring, and deployment in clinical workflows.

Table 1. Summary of AI Applications in ADPKD
AI ModalityApplication DomainValidation TypePerformance MetricClinical Utility
U-net (nnUNet)Diagnosis (TKV Segmentation)DSC 0.96, TKV error 1.8%DSC 0.96, TKV error 1.8%Reduces manual segmentation time from 56 to 8.5 minutes
U-net + EfficientNetDiagnosis (MRI TKV Automation)DSC 0.97–0.98, Time reduction 51%DSC 0.97–0.98, Time reduction 51%Reduces expert time, enables scalable use
U-net (Axial/Coronal)Diagnosis (Axial/Coronal TKV)DSC 0.89 (Axial), 0.82 (Coronal)DSC 0.89 (Axial), 0.82 (Coronal)Comparable to experts, axial images more accurate
CNNDiagnosis (Phenotype Classification)Accuracy 98.01%Accuracy 98.01%Automates typical vs. atypical classification
XGBoostPrognosis (Risk Prediction)AUC 0.96 (CKD ≥3A/3B), r = 0.81 (eGFR decline)AUC 0.96 (CKD ≥3A/3B), r = 0.81 (eGFR decline)Stratifies patients by progression risk
DL Ensemble (MRI biomarkers)Prognosis (Progression Tracking)Fast TKV growth >5%, multiorgan imaging biomarkersFast TKV growth >5%, multiorgan imaging biomarkersTracks TKV, liver volume, and more over time

Digital Object Identifier (DOI)