The Effect of Frequent and Occasional Dialysis‐Associated Hypotension on Survival of Patients on Hemodialysis
Bibliographic record
Abstract
Frequent or occasional symptomatic intradialytic hypotension during hemodialysis may influence patients' well being, but its effects on survival, independent of comorbidities, have not previously been investigated. Objective: To assess the effect of frequent (f‐IDH) or occasional (o‐IDH) dialysis‐associated hypotension on survival. Methods: During the run in period in 1998, 77 patients with f‐IDH (≥10 hypotensive events/10 months, responding only to medical intervention) and 101 patients with o‐IDH (1 or 2 events/10 months) were identified among all 958 prevalent chronic hemodialysis patients of a network. Eighty‐five patients who had no hypotensive episodes (no‐IDH) served as controls. Patients were followed for a median of 27 months (range 0.3–37), and survival of patients was compared by log‐rank test. Independent association of f‐IDH and o‐IDH on survival, compared to no‐IDH, was assessed by proportional hazards model that included patient's demographics, laboratory data, comorbidity as well as medications. Results: Forty‐five patients (58%) with f‐IDH, 47 (47%) with o‐IDH, and 33 (39%) with no‐IDH died during the follow up that represents mortality rates of 37 (p = 0.013 vs. no‐IDH), 26 (p = 0.375 vs. no‐IDH), and 21 deaths/100 patient years in the three groups, respectively. In multivariate proportional hazards regression, where age, sex, time on dialysis, CHD, diabetes, Kt/V, albumin level, use of beta‐blockers, calcium‐channel blockers, and long‐acting nitrates have been adjusted for, neither f‐IDH nor o‐IDH was associated with survival. Conclusion: Mortality in patients with f‐IDH is significantly higher than in those without such events. Our data, however, did not provide evidence that f‐IDH, independent of age and comorbidities, contributes to mortality in these patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".