Fig. 5: Description of the clinical application scenarios for the KIDS and human and artificial intelligence comparison studies.

A The KIDS system can be applied in the following two clinical scenarios: scenario 1 involves CKD screening based on retinal images. When a participant arrives at a primary care setting, the KIDS can identify potential CKD cases from retinal images and recommend referrals for suspicious cases to specialized clinics, enabling early detection and timely intervention for CKD patients. Scenario 2: Noninvasive pathological diagnosis. In specialist nephrology clinics, the KIDS is expected to provide objective pathological diagnosis and predict adverse outcomes without the need for invasive renal biopsy. This information can assist nephrologists in making precise treatment decisions and managing patients with personalized care. B A human and artificial intelligence comparison study was performed to evaluate the performance of the KIDS compared with that of nephrologists in diagnosing pathology via ROC curves. C ROC curve plots revealed that the KIDS achieved greater sensitivity than did all the other nephrologists, except for the diagnosis of ANS, for which the sensitivities of the two experts were slightly greater than those of the KIDS. In terms of accuracy, KIDS also exhibited a greater and more stable advantage. KIDS kidney intelligent diagnosis system, ROC receiver operating characteristic, IgAN IgA nephropathy, MN idiopathic membranous nephropathy, DN diabetic nephropathy, ANS arterionephrosclerosis, MCD/FSGS idiopathic minimal change disease and focal segmental glomerulosclerosis. CN-R Chinese resident nephrologist, CN-S Chinese senior nephrologist, CN-E Chinese expert nephrologist, SO-R Somali resident nephrologist, SO-S Somali senior nephrologist, SO-E Somali expert nephrologist, SO-N Somali nephrologists. Source data are provided as a Source Data file.