Population Health-Based Machine Learning Reveals Associations Between Psychosocial Factors and Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) progresses silently and severely undermines quality of life, making early detection critical for improving patient outcomes. We present a two-part study that combines large-scale telehealth data with advanced machine learning to both classify self-reported CKD status and identify key drivers of disease. Using selected features from the Behavioral Risk Factor Surveillance System (BRFSS 2021: 438,693 samples; BRFSS 2019: 418,268 samples) and the National Health Interview Survey (NHIS 2021: 29,482 samples; NHIS 2020: 31,568 samples), we addressed missing data with nine state-of-the-art imputation methods and mitigated class imbalance via sampling strategies. Our customized stacked ensemble model achieved balanced accuracy of 72.56-76.12%, with corresponding AUROC scores of 79.59-82.29%. SHapley Additive exPlanations (SHAP) analysis, followed by clinical review, highlighted critical predictors, including regular medical check-ups, age, blood pressure, and indicators of mental health stress. These findings deliver a robust and interpretable framework for CKD risk stratification and provide actionable insights into its associated factors.