Deep Learning-Enabled Screening of Chronic Kidney Disease from Echocardiography

Chronic kidney disease (CKD) affects nearly 850 million individuals globally; the prevalence of undiagnosed CKD is 60%. Taking advantage of the relationship between CKD and cardiovascular disease, we developed a deep learning (DL) model to detect CKD from parasternal long-axis (PLAX) videos using 325,377 PLAX videos from 62,818 patients at Cedars-Sinai Medical Center (CSMC). We externally validated our model in two independent cohorts of 2,224 patients at Stanford Healthcare (SHC) and 41,611 patients at Kaiser-Permanente Northern California (KPNC). In a held-out test cohort at CSMC, our model detected any stage of CKD with an area under the curve (AUC) of 0.756 [95% confidence interval 0.749 - 0.763], with consistently strong performance in KPNC (AUC 0.718 [0.714 - 0.723]) and SHC (AUC 0.719 [0.704 - 0.735]). Our DL echo model detected CKD with robust performance at two external clinical sites, offering an avenue for noninvasive screening and improved detection rates.