Hypertension in children with poorly functioning unilateral kidneys: predictors of resolution after nephrectomy
Bibliographic record
Abstract
OBJECTIVE: To identify the outcome of nephrectomy and predictors of hypertension (HTN) resolution in children with poorly functioning unilateral kidneys (differential renal function, DRF of < 15%), as concurrent HTN is often an indication for nephrectomy. PATIENTS AND METHODS: Over a 7.5-year period, a single centre retrospective analysis of 89 children with unilateral nonfunctioning/poorly functioning kidney who underwent nephrectomy was conducted. Preoperative HTN was present in 18 children (20.2%). The childrens' characteristics (age, sex, body mass index, pathology, side), cause of nonfunction, diagnostics including preoperative proteinuria (dipstick) and DRF (nuclear scan), pathological features of specimen and follow-up were recorded. RESULTS: The mean (median; range) age at nephrectomy was 6.8 (5; 0.333-14) years with a mean (median; range) follow-up of 2.4 (3; 0.083-5.5) years. The mean (median; range) DRF was 6.5 (1; 0-15)%. Twelve of 18 children (67%) resolved their HTN. Age at nephrectomy, sex, side of nonfunctioning kidney and surgical approach (78% laparoscopic nephrectomy) did not correlate with HTN resolution. Persistence of HTN seemed to correlate with residual function of more than a DRF threshold of 5% (P = 0.05), the presence of preoperative qualitative proteinuria by dipstick (P = 0.03) and inflammation on pathology. CONCLUSIONS: HTN resolved after nephrectomy for poorly functioning unilateral kidney in most of the children. Persistence of HTN is probably multifactorial. Ipsilateral residual function before nephrectomy, preoperative proteinuria and pathological features of nephrectomy specimen may serve as clinically useful markers for outcome prediction.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".