Screening chronic kidney disease through deep learning utilizing ultra-wide-field fundus images

Xinyu Zhao; Xingwang Gu; Lihui Meng; Yongwei Chen; Qing Zhao; Shiyu Cheng; Wenfei Zhang; Tiantian Cheng; Chuting Wang; Zhengming Shi; Shengyin Jiao; Changlong Jiang; Guofang Jiao; Da Teng; Xiaolei Sun; Bilei Zhang; Yakun Li; Huiqin Lu; Changzheng Chen; Hao Zhang; Ling Yuan; Chang Su; Han Zhang; Song Xia; Anyi Liang; Mengda Li; Dan Zhu; Meirong Xue; Dawei Sun; Qiuming Li; Ziwu Zhang; Donglei Zhang; Hongbin Lv; Rishet Ahmat; Zilong Wang; Charumathi Sabanayagam; Xiaowei Ding; Tien Yin Wong; Youxin Chen

doi:10.1038/s41746-024-01271-w

Screening chronic kidney disease through deep learning utilizing ultra-wide-field fundus images

NPJ Digit Med. 2024 Oct 7;7(1):275. doi: 10.1038/s41746-024-01271-w.

Authors

Xinyu Zhao^#¹, Xingwang Gu^#¹, Lihui Meng¹, Yongwei Chen², Qing Zhao¹, Shiyu Cheng¹, Wenfei Zhang¹, Tiantian Cheng¹, Chuting Wang¹, Zhengming Shi¹, Shengyin Jiao², Changlong Jiang², Guofang Jiao³, Da Teng⁴, Xiaolei Sun⁵, Bilei Zhang⁶, Yakun Li⁷, Huiqin Lu⁸, Changzheng Chen⁹, Hao Zhang¹⁰, Ling Yuan¹¹, Chang Su¹², Han Zhang¹³, Song Xia¹⁴, Anyi Liang¹⁵, Mengda Li¹⁶, Dan Zhu¹⁷, Meirong Xue¹⁸, Dawei Sun¹⁹, Qiuming Li²⁰, Ziwu Zhang²¹, Donglei Zhang²², Hongbin Lv²³, Rishet Ahmat²⁴, Zilong Wang²⁵, Charumathi Sabanayagam²⁶, Xiaowei Ding^{27

28}, Tien Yin Wong^{29

30}, Youxin Chen³¹

Affiliations

¹ Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China and Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China.
² Department of Research, VoxelCloud, Shanghai, China.
³ Tonghua Eye Hospital of Jilin Province, Tonghua, Jilin, China.
⁴ Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁵ Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, Shandong, China.
⁶ Department of Ophthalmology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China.
⁷ Department of Ophthalmology, The Second Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China.
⁸ Department of Ophthalmology, Xi'an No. 1 Hospital, Xian, Shanxi, China.
⁹ Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
¹⁰ Department of Ophthalmology, The Fourth People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China.
¹¹ Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
¹² Department of Ophthalmology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China.
¹³ Department of Ophthalmology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
¹⁴ Department of Ophthalmology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.
¹⁵ Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China.
¹⁶ Eye Center, Beijing Tsinghua Changgung Hospital, Beijing, China and School of Clinical Medicine, Tsinghua University, Beijing, China.
¹⁷ Department of Ophthalmology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot, Inner Mongolia, China.
¹⁸ Department of Ophthalmology, Hainan Hospital of PLA General Hospital, Sanya, Hainan, China.
¹⁹ Department of Ophthalmology, The Second Affiliated Hospital, Harbin Medical Medical, Harbin, Heilongjiang, China.
²⁰ Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
²¹ Department of Ophthalmology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
²² Department of Ophthalmology, The First Affiliated Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
²³ Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
²⁴ Department of Ophthalmology, Bayinguoleng People's Hospital, Korla, Xinjiang, China.
²⁵ Microsoft Research Asia (Shanghai), Shanghai, China.
²⁶ Singapore Eye Research Institute, Singapore and National Eye Centre, Singapore, Singapore.
²⁷ Department of Research, VoxelCloud, Shanghai, China. dingxiaowei@sjtu.edu.cn.
²⁸ Department of Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China. dingxiaowei@sjtu.edu.cn.
²⁹ Eye Center, Beijing Tsinghua Changgung Hospital, Beijing, China and School of Clinical Medicine, Tsinghua University, Beijing, China. wongtienyin@tsinghua.edu.cn.
³⁰ Tsinghua Medicine, Tsinghua University, Beijing, China. wongtienyin@tsinghua.edu.cn.
³¹ Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China and Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China. ChenYX@pumch.cn.

^# Contributed equally.

Abstract

To address challenges in screening for chronic kidney disease (CKD), we devised a deep learning-based CKD screening model named UWF-CKDS. It utilizes ultra-wide-field (UWF) fundus images to predict the presence of CKD. We validated the model with data from 23 tertiary hospitals across China. Retinal vessels and retinal microvascular parameters (RMPs) were extracted to enhance model interpretability, which revealed a significant correlation between renal function and RMPs. UWF-CKDS, utilizing UWF images, RMPs, and relevant medical history, can accurately determine CKD status. Importantly, UWF-CKDS exhibited superior performance compared to CTR-CKDS, a model developed using the central region (CTR) cropped from UWF images, underscoring the contribution of the peripheral retina in predicting renal function. The study presents UWF-CKDS as a highly implementable method for large-scale and accurate CKD screening at the population level.

Abstract

Grants and funding