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Abstract Predicting the transition of kidney function in chronic kidney disease is difficult as specific symptoms are lacking and often overlooked, and progress occurs due to complicating factors. In this study, we applied time-series cluster analysis and a light gradient boosting machine to predict the trajectories of kidney function in non-dialysis dependent chronic kidney disease patients with baseline estimated glomerular filtration rate (GFR) ≥ 45 mL/min/1.73 m2. Based on 5-year changes in estimated GFR, participants were stratified into groups with similar trajectories by cluster analysis. Next, we applied the light gradient boosting machine algorithm and Shapley addictive explanation to develop a prediction model for clusters and identify important parameters for prediction. Data from 780 participants were available for analysis. Participants were classified into five classes (Class 1: n = 78, mean [± standard deviation] estimated GFR 100 ± 19.3 mL/min/1.73 m2; Class 2: n = 176, 76.0 ± 9.3 mL/min/1.73 m2; Class 3: n = 191, 59.8 ± 5.9 mL/min/1.73 m2; Class 4: n = 261, 52.7 ± 4.6 mL/min/1.73 m2; and Class 5: n = 74, 53.5 ± 12.0 mL/min/1.73 m2). Declines in estimated GFR were 8.9% in Class 1, 12.2% in Class 2, 4.9% in Class 3, 12.0% in Class 4, and 45.1% in Class 5 during the 5-year period. The accuracy of prediction was 0.675, and the top three most important Shapley addictive explanation values were 1.61 for baseline estimated GFR, 0.12 for hemoglobin, and 0.11 for body mass index. The estimated GFR transition of patients with preserved chronic kidney disease mostly depended on baseline estimated GFR, and the borderline for estimated GFR trajectory was nearly 50 mL/min/1.73 m2.

Abstract Background In the Japanese guidelines on combination peritoneal dialysis (PD) and hemodialysis (HD) therapy, patients with serum beta 2 microglobulin (β2MG) levels less than 30 mg/L are recommended. And PD patients with β2MG more than 30 mg/L are considered to transfer to the PD + HD combination therapy. However, the resultant changes in serum β2MG levels by the introduction of PD + HD combination therapy and the factors influencing the change have not clearly elucidated. Methods We retrospectively studied 11 PD patients (mean age 56.4 ± 12.9 years, 10 males) with baseline β2MG levels > 30 mg/L with respect to changes in β2MG and its related factors for 12 months after the introduction of combination therapy of PD plus once a week HD (4 h) using a high-performance dialyzer. Laboratory data including hemoglobin, albumin, C-reactive protein, blood urea nitrogen, creatinine, and the patients’ demographic profiles, and HD-related factors, such as Kt/V and blood flow rate, were assessed. Results Serum β2MG levels decreased statistically significantly after the introduction of combination therapy: from 36.7 ± 6.7 mg/L at 0 months, to 33.4 ± 6.1 mg/L at 3 months (p = 0.030, compared to baseline), 32.9 ± 4.5 mg/L at 6 months (p = 0.009), and 33.3 ± 5.3 mg/L at 12 months (p = 0.023), respectively. However, only 27–36% patients achieved target β2MG levels of