Evidence map›Paper›PMID 40814612›Full record

ArticleKidney international reports2025

Chronic Changes on Kidney Histology by a Multiclass Artificial Intelligence Model.

Aleksandar Denic, Muhammad S Asghar, Lucas Stetzik, Austin Reynolds, Jaidip M Jagtap, Mahesh Kumar, Aidan F Mullan, Andrew R Janowczyk, Mariam P Alexander, Maxwell L Smith and 3 more

Abstract read
In one paragraph

Article in Kidney international reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Aleksandar DenicDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
Muhammad S AsgharDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
Lucas StetzikAiforia Inc, Cambridge Innovation Center, Cambridge, Massachusetts, USA.
Austin ReynoldsDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
Jaidip M JagtapDepartment of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Mahesh KumarDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
Aidan F MullanDivision of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA.
Andrew R JanowczykDepartment of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia, USA.
Mariam P AlexanderDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Maxwell L SmithDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Arizona, USA.
Fadi E SalemDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida, USA.
Laura BarisoniDepartment of Pathology, Division of AI and Computational Pathology, Duke University, Durham, North Carolina, USA.
Andrew D RuleDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.

Funding

The macro- and micro- anatomy and pathology of the aging kidneyR01DK090358 · NIDDK · MAYO CLINIC ROCHESTER · PI ANDREW David RULE · 2011 to 2026
$9.9M
NIDDK NIH HHS R01 DK090358
6 · The paper itself

Abstract

Introduction: Chronic changes in kidney histology are often approximated by using human vision but with limited accuracy. Methods: An interactive annotation tool trained an artificial intelligence (AI) model for segmenting structures on whole slide images (WSIs) of kidney tissue. A total of 20,509 annotations trained the AI model with 20 classes of structures, including separate detection of cortex from medulla. We compared the AI model detections with human-based annotations in an independent validation set. The AI model was then applied to 1426 donors and 1699 patients with renal tumor to calculate chronic changes as defined by measures of nephron size (glomerular volume, cortex volume per glomerulus, and mean tubular areas) and nephrosclerosis (globally sclerotic glomeruli, increased interstitium, increased tubular atrophy (TA), arteriolar hyalinosis (AH), and artery luminal stenosis from intimal thickening). We then assessed whether chronic kidney disease (CKD) outcomes were associated with these chronic changes. Results: During the AI model validation step, the agreement between the AI detections and human annotations was similar to the agreement between human pairs, except that the AI model showed less agreement with AH. Chronic changes calculated solely from AI-based detections associated with low glomerular filtration rate (GFR) during follow-up after kidney donation and with kidney failure after a radical nephrectomy for tumor. A chronicity score based on AI detections was calculated from cortex per glomerulus, percent glomerulosclerosis, TA foci density, and mean area of AH lesions and showed good prognostic discrimination for kidney failure (cross-validation C-statistic = 0.819). Conclusion: A multiclass AI model can help automate quantification of chronic changes on WSIs of kidney histology.

Indexed as

artificial intelligencechronic kidney diseasedigital pathologykidney histologynephron sizenephrosclerosis

Identifiers

PMID40814612
PMCPMC12347913

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.