A Clinically Interpretable Deep CNN Framework for Early Chronic Kidney Disease Prediction Using Grad-CAM-Based Explainable AI

Abstract: Chronic Kidney Disease (CKD) constitutes a major global medical burden, marked by the gradual deterioration of renal function, which results in the impaired clearance of metabolic waste and disturbances in systemic fluid homeostasis. Owing to its substantial contribution to worldwide morbidity and mortality, the development of reliable and efficient diagnostic approaches is critically important to facilitate early detection and prompt clinical management. This study presents a deep convolutional neural network (CNN) for early CKD detection from CT kidney images, complemented by class balancing using Synthetic Minority Over-sampling Technique (SMOTE) and interpretability via Gradient-weighted Class Activation Mapping (Grad-CAM). The model was trained and evaluated on the CT KIDNEY DATASET, which contains 12,446 CT images, including 3,709 cyst, 5,077 normal, 1,377 stone, and 2,283 tumor cases. The proposed deep CNN achieved a remarkable classification performance, attaining 100% accuracy in the early detection of chronic kidney disease (CKD). This significant advancement demonstrates strong potential for addressing critical clinical diagnostic challenges and enhancing early medical intervention strategies.