Development of a fuzzy expert system for the nephropathy control assessment in patients with type 2 diabetes mellitus

Diabetic nephropathy is a life-threatening complication if not controlled properly. Early detection and effective control prevent its progression. In this study, the development of a Fuzzy Expert System (FES) is proposed to help doctors assess the nephropathy control in patients with Type 2 Diabetes Mellitus (T2DM). The study is based on a FES that was developed with the use of Clinical Practice Guidelines (CPG), data bases and the expertise of a team of doctors. It considers the use of input variables such as Glomerular Filtration Rate (GFR), serum creatinine, blood glucose, Type 2 Diabetes Mellitus Age (T2DMA), uric acid, hypertension and dyslipidemia. All these factors, give an efficient nephropathy control assessment. Sixty tests were performed using the expertise of a team of doctors, the expected results were compared with those estimated by the FES (using the same cases), and it was observed that the FES succeeds in up to 93.33% of the cases. The response surface analysis shows that GFR, serum creatinine and hypertension have a greater impact in the nephropathy control. This system supports the doctors in nephropathy control, but it does not estimate the renal failure stages. Nephropathy control is a clinical problem that includes uncertainty and inaccuracy, so the use of a FES is recommended to overcome this problem, since fuzzy systems help to assess the inherent uncertainty degree.