A Practical Electronic Health Record-Based Dry Weight Supervision Model for Hemodialysis Patients

IEEE J Transl Eng Health Med. 2019 Oct 24:7:4200109. doi: 10.1109/JTEHM.2019.2948604. eCollection 2019.

Abstract

Objective: Dry Weight (DW) is a typical hemodialysis (HD) prescription for End-Stage Renal Disease (ESRD) patients. However, an accurate DW assessment is difficult due to the complication of body components and individual variations. Our objective is to model a clinically practicable DW estimator. Method: We proposed a time series-based regression method to evaluate the weight fluctuation of HD patients according to Electronic Health Record (EHR). A total of 34 patients with 5100 HD sessions data were selected and partitioned into three groups; in HD-stabilized, HD-intolerant, and near-death. Each group's most recent 150 HD sessions data were adopted to evaluate the proposed model. Results: Within a 0.5 kg absolute error margin, our model achieved 95.44%, 91.95%, and 83.12% post-dialysis weight prediction accuracies for the HD-stabilized, HD-intolerant, and near-death groups, respectively. Within a 1%relative error margin, the proposed method achieved 97.99%, 95.36%, and 66.38% accuracies. For HD-stabilized patients, the Mean Absolute Error (MAE) of the proposed method was 0.17 kg ± 0.04 kg. In the model comparison experiment, the performance test showed that the quality of the proposed model was superior to those of the state-of-the-art models. Conclusion: The outcome of this research indicates that the proposed model could potentially automate the clinical weight management for HD patients. Clinical Impact: This work can aid physicians to monitor and estimate DW. It can also be a health risk indicator for HD patients.

Keywords: Personalized prognosis; electronic health record; hemodialysis; personalized risk prediction.

Grants and funding

This work was supported in part by the Shanghai Science and Technology Commission Innovation Action Plan Project under Grant 17411950701, the National Key Research and Development Program of China under Grant 2018YFC2002000, the Shanghai Sailing Program under Grant 19YF1405600, the Shanghai Natural Science under Grant 16ZR1449400, and the China Natural Science under Grant 81600577.