Applying Random Forest Model Algorithm to GFR Estimation

Background The utilization of estimating-GFR equations is critical for kidney disease in the clinic. However, the performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has not improved substantially in the past eight years. Here we hypothesized that random forest regression(RF) method could go beyond revised linear regression, which is used to build the CKD-EPI equationMethods 1732 participants were enrolled in this study totally (1333 in development data set from Tianhe District and 399 in external data set Luogang District). Recursive feature elimination (RFE) is applied to the development data to select important variables and build random forest models. Then same variables were used to develop the estimated GFR equation with linear regression as a comparison. The performances of these equations are measured by bias, 30% accuracy , precision and root mean square error(RMSE).Results Of all the variables, creatinine, cystatin C, weight, body mass index (BMI), age, uric acid(UA), blood urea nitrogen(BUN), hematocrit(HCT) and apolipoprotein B(APOB) were selected by RFE method. The results revealed that the overall performance of random forest regression models ascended the revised regression models based on the same variables. In the 9-variable model, RF model was better than revised linear regression in term of bias, precision ,30%accuracy and RMSE(0.78 vs 2.98, 16.90 vs 23.62, 0.84 vs 0.80, 16.88 vs 18.70, all P<0.01 ). In the 4-variable model, random forest regression model showed an improvement in precision and RMSE compared with revised regression model. (20.82 vs 25.25, P<0.01, 19.08 vs 20.60, P<0.001). Bias and 30%accurancy were preferable, but the results were not statistically significant (0.34 vs 2.07, P=0.10, 0.8 vs 0.78, P=0.19, respectively).Conclusions The performances of random forest regression models are better than revised linear regression models when it comes to GFR estimation.