Abstract 588: Attenuation of Flow- and Nitrate-mediated Vasodilation in End-stage Renal Disease by Inflammation, Hyperphosphatemia and Hyperparathyroidism: Correction with Fall in C-reactive Protein by Nocturnal Hemodialysis
Bibliographic record
Abstract
Background: Endothelium-dependent vasodilation (EDV) and endothelium-independent vasodilation (EIV) are impaired in end-stage renal disease (ESRD), yet improve soon after conversion from conventional (CHD) to nocturnal hemodialysis (NHD). Methods and Results: To test the hypotheses that suppression of inflammation and correction of hyperphosphatemia contribute to such improvement, dialysis dose, blood pressure (BP), brachial artery EDV and EIV, plasma C reactive protein (CRP), phosphate (Pi) and parathyroid hormone (PTH) were determined before, 1 and 2 months after conversion to NHD (n=23; mean age: 43±2 years [mean±SEM]). NHD increased dialysis dose, EDV and EIV (all p<0.05) and lowered simultaneously measured BP, Pi and PTH (all p<0.05) and CRP (from 14.8±3.9 to 6.63±2.1 mg/L after 2 months, p<0.01). Overall, there was a significant inverse relationship between EDV and log 10 CRP (r=−0.35, p=0.008). Pre-specified dichotomization by CHD Pi identified higher BP with Pi <1.8mM (n=10): (147±10/87±7 vs. 131±4/75±2 mmHg, p<0.01), yet after 1 month both groups were normotensive. In those with Pi <1.8mM, 1 month of NHD lowered CRP and increased EDV from −2.4±2.4 to 7.5±1.8% (p<0.05). In contrast, in the high Pi group, NHD lowered Pi (p<0.05) but had no significant effect on CRP, PTH or EDV (−0.8±1.1 vs. −0.6±1.6 %) but after 2 months, Pi and PTH fell and EDV and EIV improved. Conclusions: Correction of uremia and hypertension alone does not improve endothelial and smooth muscle brachial artery dilation in ESRD; contributions of systemic inflammation, altered Pi balance and hyperparathyroidism to impaired EDV and EIV must also be addressed. We provide the first demonstration that NHD reduces CRP.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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) | 0.006 | 0.001 |
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".