Topic Discussion: Calcium and Pre-eclampsia- using AI

 I now am re-doing the post on using calcium to prevent pre-eclampsia using artificial intelligence website- https://chat.openai.com/chat 

Prompt: Can calcium prevent PEC?

Response: 

Calcium supplementation has been shown to reduce the risk of pre-eclampsia in pregnant women who have low dietary calcium intake or are at high risk for pre-eclampsia. However, it is important to note that calcium supplementation is not a guaranteed prevention method for pre-eclampsia and should only be taken under the guidance of a healthcare professional.

The World Health Organization (WHO) recommends that pregnant women receive at least 1,500 mg of calcium per day, either through diet or supplementation, to reduce the risk of pre-eclampsia. In cases where dietary calcium intake is insufficient, calcium supplements may be recommended.

It is important to note that pre-eclampsia is a complex condition that can have various causes, and calcium supplementation alone may not prevent it in all cases. Other preventative measures such as maintaining a healthy lifestyle, attending regular prenatal checkups, and managing pre-existing health conditions can also help reduce the risk of pre-eclampsia.

Several studies have investigated the effectiveness of calcium supplementation in preventing pre-eclampsia. Here are some key findings:

1. A Cochrane review of 13 randomized controlled trials involving over 15,000 women found that calcium supplementation reduced the risk of pre-eclampsia by 55% in women with low calcium intake and by 24% in women at high risk for pre-eclampsia.

2. A meta-analysis of 21 trials involving over 23,000 women found that calcium supplementation reduced the risk of pre-eclampsia by 24%, with a greater effect seen in women with low dietary calcium intake.

3. A study published in the British Medical Journal found that calcium supplementation reduced the risk of pre-eclampsia by 66% in women with a history of pre-eclampsia.

Overall, the data suggests that calcium supplementation can be an effective preventative measure against pre-eclampsia, especially in women with low dietary calcium intake or a history of pre-eclampsia. However, it is important to note that calcium supplementation should only be taken under the guidance of a healthcare professional, as excessive calcium intake can have adverse effects.

When I asked to provide references:

Sure, here are some references for the information I provided:

1. Hofmeyr GJ, Lawrie TA, Atallah AN, Duley L, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2018;10(10):CD001059. doi:10.1002/14651858.CD001059.pub5

2. Hofmeyr GJ, Manyame S, Medley N, Williams MJ, Kramer MS, Duley L. Calcium supplementation commencing before or early in pregnancy, or food fortification with calcium, for preventing hypertensive disorders of pregnancy. Cochrane Database Syst Rev. 2019;10(10):CD011192. doi:10.1002/14651858.CD011192.pub2

3. Villar J, Abdel-Aleem H, Merialdi M, et al. World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women. Am J Obstet Gynecol. 2006;194(3):639-649. doi:10.1016/j.ajog.2005.10.831

4. Buppasiri P, Lumbiganon P, Thinkhamrop J, Ngamjarus C, Laopaiboon M. Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes. Cochrane Database Syst Rev. 2015;(2):CD007079. doi:10.1002/14651858.CD007079.pub3

5. Levine RJ, Hauth JC, Curet LB, et al. Trial of calcium to prevent preeclampsia. N Engl J Med. 1997;337(2):69-76. doi:10.1056/NEJM199707103370201

Topic Discussion: Artificial Intelligence in Nephrology

Artificial intelligence(AI) is on a rise in science. Using it in medicine and specifically nephrology is sure to come.

According to the dictionary, AI is “the theory and development of computer systems able to perform tasks that normally require human intelligence, such as visual perception, speech recognition, decision-making, and translation between languages.”

Dr Eric Topol has been a big proponent of this concept in medicine for years and recently has written a book called “Deep Medicine “ that details the potential uses of this in medicine.

Basically, AI can help in three main ways: 1) diagnosis that is often challenging in various challenging syndromes and even basic common ones. 2) make the physician’s life easier and decrease paper work and finally leading to the third -the most important 3) spending more time at the bedside.

AI is done via creating an  artificial neural network (ANN ) which is simply a collection of artificial neurons organized in layers. In a recent article in AJKD, authors discuss the potential use of this concept in Nephrology. They describe using it for IgA nephropathy(IgAN) as a recognizable cause for AKI. The ability to identify the patients that will progress to ESRD with IgAN would be useful for prognostic and therapeutic reasons. Geddes et al hypothesized that there exists a function that associates clinical and biological parameters measured at the time of IgAN diagnosis (namely age, sex, blood pressure, proteinuria, serum creatinine level, and antihypertensive treatments) to the probability of developing progressive IgAN. The authors designed and implemented an ANN to approximate this function. The results showed that their ANN could predict the occurrence of progressive IgAN more accurately than experienced nephrologists (correct predictions, 87% vs 69.4%; sensitivity, 86.4% vs 72%; and specificity, 87.5% vs 66%). Hmm, now this might be interesting to help guide a lot of therapies in Nephrology. This might be very useful in transplantation and prognosticating even need for dialysis for the elderly CKD patients.

Interestingly, many AI algorithms have been approved by FDA that are used in clinical practice:- some examples are of Atrial fibrillation detection, EF ECHO determination, Coronary calcium scoring, CT brain bleed diagnosis, device for paramedic stroke diagnosis, breast density via mammography to name a few.  No nephrology related such algorithms are approved to my knowledge.

There is an entire journal dedicated for this in medicine now

https://www.journals.elsevier.com/artificial-intelligence-in-medicine

Nephrologists, let’s get started and catch on!