Background. Chronic kidney disease (CKD) is a covert disease. Accurate prediction of CKD progression over time is necessary for reducing its costs and mortality rates. The present study proposes an adaptive neurofuzzy inference system (ANFIS) for predicting the renal failure timeframe of CKD based on real clinical data. Methods. This study used 10-year clinical records of newly diagnosed CKD patients. The threshold value of 15 cc/kg/min/1.73 m2 of glomerular filtration rate (GFR) was used as the marker of renal failure. A Takagi-Sugeno type ANFIS model was used to predict GFR values. Variables of age, sex, weight, underlying diseases, diastolic blood pressure, creatinine, calcium, phosphorus, uric acid, and GFR were initially selected for the predicting model. Results. Weight, diastolic blood pressure, diabetes mellitus as underlying disease, and current GFR(t) showed significant correlation with GFRs and were selected as the inputs of model. The comparisons of the predicted values with the real data showed that the ANFIS model could accurately estimate GFR variations in all sequential periods (Normalized Mean Absolute Error lower than 5%). Conclusions. Despite the high uncertainties of human body and dynamic nature of CKD progression, our model can accurately predict the GFR variations at long future periods.

Funding Acknowledgements Type of funding sources: None. Background Paralympic athletes are a special group of elite athletes with unique cardiovascular issues. Recently, the term "Paralympic medicine" has been used to describe the specific medical conditions of athletes participating in the Paralympics. However, there are limited data regarding cardiovascular screening in Paralympic athletes. Purpose To assess the prevalence of normal and abnormal cardiac findings and cardiovascular risk factors in a subset of male Paralympic athletes. Methods From April 2019 to July 2021, male Paralympic athletes who were selected for participation in Paralympic Games in non-endurance sports disciplines, underwent cardiac screening including history, physical examination, 12-leads electrocardiogram (ECG), echocardiography and blood test. Athletes were classified according to the sports disciplines into three groups: 1) skill (archery, shooting, taekwondo, judo); 2) power (weightlifting, discus throwing, shot putting, javelin throwing) and 3) mixed (sitting volleyball, wheelchair basketball, rowing). As well as divided base on the type of disability into two groups: 1) athletes with spinal cord injury (SCI), and 2) athletes with non-spinal cord injuries (NSCI). All ECG were interpreted according to international recommendations for ECG interpretation in athletes. Results Among 82 Paralympic athletes (mean age, 33.7 [21-49] years), there were 19 (23%) in skill, 25 (31%) in power, and 38 (46%) in mixed sports disciplines and 24 (30%) had SCI and 58 (70%) had NSCI. There were no abnormalities observed in two-dimensional echocardiography. Normal ECG findings were seen in 28 athletes (34.1%) with a higher prevalence in athletes with NSCI (41.3%) and participated in mixed (47.3%) sports discipline (p<0.001). Borderline ECG findings were detected in 6 (7.3%) with more frequent in athletes with SCI (12.5%) and participated in power (16%) sports disciplines (p<0.001). The prevalence of abnormal ECG findings were 3.6% and there was no significant difference regard to type of disability and sports disciplines. Cardiac risk factors including hypertension was detected in 8 (9.7%); triglycerides >200 mg/dl in 21 (25.6%), total cholesterol >200 mg/dl in 15 (18.2%), 25-hydroxyvitamin D3 <30 ng/ml in 35 (42.6%), low-density lipoprotein cholesterol >130 mg/dl in 8 (9.7%), very low-density lipoprotein cholesterol ≥50 mg/dl in 15 (18.2%) and high-density lipoprotein cholesterol <40 mg/dl in 7 (8.5%); that were significantly more frequent in athletes with SCI and athletes participated in power sports disciplines (p<0.001). Conclusions The overall prevalence of borderline ECG findings and cardiovascular risk factors are unexpectedly high in Paralympic athletes. This study emphasizes that Paralympic athletes especially those with SCI and participating in power sports disciplines are not immune from cardiovascular risk factors and requires more medical care attention through relevant cardiovascular screening strategies.

No abstract

No abstract