XEns-CKD: An Explainable Ensemble-Based Approach for Chronic Kidney Disease Stage Detection
This study addresses the challenge of early chronic kidney disease (CKD) detection, which is hindered by its asymptomatic onset and consequent delays in staging and intervention. To overcome this, the authors propose a novel approach that integrates an ensemble of Vision Transformers (ViTs) with multiple interpretable AI techniques to enable precise classification of ultrasound images across normal kidneys and all five CKD stages—a first in the field. The method leverages LIME, Layer-wise Relevance Propagation (LRP), and a newly introduced Attention-Min/Max fusion strategy to effectively localize and interpret diagnostically critical regions. Evaluated on a private renal ultrasound dataset, the model achieves an overall accuracy of 86.36%, outperforming existing methods by 4% and demonstrating superior performance across multiple macro-level metrics while maintaining both high diagnostic accuracy and strong interpretability.