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The International Journal of the Royal Society of Thailand
Volume XI - 2019

by using AI prediction (Table2). One study use AI to predict complications in ESRD
patients receiving hemodialysis. Another study use AI in dry weight adjustment
(Niel and Bastard, 2019; Putra et al., 2019). To author’s knowledge, there is no study

of AI in SLED and this could be the future research opportunity. Due to complexity
of critically ill patients, large databases are required to create well-trained AI.

Opposite to SLED, dedicated machine and experienced specialists are
required in CRRT. In addition, the anticoagulants are required to increase circuit
lifetime. Among anticoagulants choices, citrate is the first line anticoagulant
recommended by KDIGO guideline due to less complication from systemic
bleeding and heparin induced thrombocytopenia (Brandenburger et al., 2017;
Khwaja, 2012). Adjustment of citrate anticoagulant required serial monitoring of
ionized calcium in circuit and systemic (Tolwani and Wille, 2012). Unsurprisingly,
adjustment of CRRT machine setting and citrate anticoagulant flow rate might cause
problems in unfamiliar nephrologists. Complications that might developed include
citrate intoxication, electrolyte imbalance and CRRT under dosing (Khadzhynov
et al., 2014; Neyra and Tolwani, 2019). AI can be incorporated into application
to assist nephrologist in these aspects. Unlike simple calculator application,
application with AI can make suggestions of what nephrologists should do in
certain situations (Ricci and Ronco, 2007).

Conclusions

AKI, a complex disease involving multiple cells of kidney, is not fully
understood with current medical technologies. Precision medicine is one of the
emerging fields in medicine and could be used to explain the complexity of many
diseases in the future. It includes using of new technologies in genomics and
computer science. Moreover, the benefits of precision medicine are not limited

to the discovery the pathology of diseases. These technologies can be used to
facilitate many aspect AKI caring processes such as risk prediction, delaying AKI
progression and preventing AKI complications. Precision medicine would be
an important part in medicine in the future. Understanding the basic principle of
precision medicine could help medical personals in learning of upcoming medical
knowledge.

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