Review Article: Artificial Intelligence in Medicine Development of Artificial Intelligence Systems for Chronic Kidney Disease

Chronic kidney disease (CKD) is a complex disease that is related not only to dialysis but also to the onset of cardiovascular disease and life prognosis. As renal function declines with age and depending on lifestyle, the number of patients with CKD is rapidly increasing in Japan. Accurate prognosis prediction for patients with CKD in clinical settings is important for selecting treatment methods and screening patients with high-risk. In recent years, big databases on CKD and dialysis have been constructed through the use of data science technology, and the pathology of CKD is being elucidated. Therefore, we developed an artificial intelligence (AI) system that can accurately predict the prognosis of CKD such as its progression, the timing of dialysis introduction, and death. Aiming for its social implementation, the prognosis prediction system developed for patients with CKD was released on the website. We then developed a clinical practice guideline creation support system called Doctor K as an AI system. When creating clinical practice guidelines, huge amounts of manpower and time are required to conduct a systematic review of thousands of papers. Therefore, we developed a natural language processing (NLP) AI system to significantly improve work efficiency. Doctor K was used in the preparation of the guidelines of the Japanese Society of Nephrology. Furthermore, by comparing and analyzing the medical word virtual space constructed by the NLP AI system based on patient big data, we proved using the latest mathematical theory (category theory) that this system reflects the pathology of CKD. This suggests the possibility that the NLP AI system can predict patient prognosis. We hope that, through these studies, the use of AI based on big data will lead to the development of new treatments and improvement in patient prognosis.