DeepECG-Kidney: A Deep Learning Model for Non-Invasive Detection of Impaired Kidney Function Using Electrocardiography

 

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DeepECG-Kidney: A Deep Learning Model for Non-Invasive Detection of Impaired Kidney Function Using Electrocardiography

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Jung Nam
An
Jung Nam An lovingjn@gmail.com Hallym University Sacred Heart Hospital Internal Medicine Anyang-si, Gyeonggi-do Korea (Republic of) *
Yeongyeon Na yeongyeon.na@vuno.co VUNO Inc. VUNO Inc. Seoul Korea (Republic of) -
Hyun Jin Ahn hyunjin.ahn@vuno.co VUNO Inc. VUNO Inc. Seoul Korea (Republic of) -
HYUNWOO PARK andyr2d2@hallym.or.kr Hallym University Sacred Heart Hospital Internal Medicine Anyang-si, Gyeonggi-do Korea (Republic of) -
Sunghoon Joo sunghoon.joo@vuno.co VUNO Inc. VUNO Inc. Seoul Korea (Republic of) -
Mineok Chang mineok.chang@vuno.co VUNO Inc. VUNO Inc. Seoul Korea (Republic of) -
Do Hyoung Kim dhkim6489@gmail.com Hallym University Kangnam Sacred Heart Hospital Internal Medicine Seoul Korea (Republic of) -
Minje Park minje.park@vuno.co VUNO Inc. VUNO Inc. Seoul Korea (Republic of) -
Dong Geum Shin blau07@hallym.or.kr Hallym University Kangnam Sacred Heart Hospital Internal Medicine Seoul Korea (Republic of) -
Yeha Lee yeha.lee@vuno.co VUNO Inc. VUNO Inc. Seoul Korea (Republic of) -
Sung Gyun Kim imnksk@gmail.com Hallym University Sacred Heart Hospital Internal Medicine Anyang-si, Gyeonggi-do Korea (Republic of) -
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Impaired kidney function is often asymptomatic, delaying diagnosis and treatment. The utility of electrocardiography (ECG) in identifying impaired kidney function has not been fully explored. We aimed to develop and validate a deep learning algorithm using ECG data to detect impaired kidney function.

We retrospectively analyzed over 1.3 million ECGs (250 thouand pateints) from two tertiary hospitals in Korea. DeepECG-Kidney30 and DeepECG-Kidney60 models were developed using Vision Transformer architecture to identify individuals with estimated glomerular filtration rate <30 and <60 mL/min/1.73 m², respectively. Model performance was assessed using area under the receiver operating characteristics curve(AUROC) across 12-Lead, Limb-Lead(I, II, III, aVR, aVL, and aVF), and Lead-I ECGs.

The DeepECG-Kidney30 model achieved AUROC values of 0.9126 (12-Lead), 0.8903 (Limb-Lead), and 0.8807 (Lead-I) in the internal test set, and 0.9152, 0.8977, and 0.8869, respectively, in the external validation cohort. DeepECG-Kidney60 demonstrated similar performance with slightly lower AUROC values. Performance was consistent across subgroups, with notably higher accuracy in individuals <65 years and in ECGs without overt abnormalities. Models using reduced lead sets also maintained high accuracy, indicating feasibility for wearable device integration. Pretraining with a masked autoencoder further enhanced model performance.

Our ECG-based deep learning models accurately detected impaired kidney function across various lead configurations, supporting their clinical utility as non-invasive tools for impaired kidney function screening—even in wearable device settings.

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