Increased dialyzer reuse with citrate dialysate
Bibliographic record
Abstract
Dialyzer reuse is limited by the clotting of blood, which blocks the fibers and reduces the membrane surface area. Clotting during treatment may also reduce dialysis efficiency and potentially decrease delivered dose, Kt/V(urea). A new dialysate containing citric acid, instead of the standard acetic acid, as the acidifying agent has become available and is associated with reduced clotting during acute dialysis treatments. The effect of citric acid dialysate on dialyzer reuse was evaluated in this prospective, controlled, multicenter study involving maintenance hemodialysis patients. A total of 105 patients from five dialysis units were switched to the new dialysate and new dialyzers. Reuse outcome on the new dialysate was compared with the reuse on the regular acetic acid containing bicarbonate dialysate (controls). The overall reuse with citrate dialysate increased significantly from 15.1 +/- 9.4 to 18 +/- 10.0 (mean +/- SD) on regular and citrate dialysate, respectively (p = 0.0003). The most significant increase was seen in those patients who had limited reuse before the switch to citrate dialysate; 51, 59, and 134% increases occurred in those with 10 to 15, 5 to 10, and < 5 reuses at controls, respectively. Interestingly, the 10 patients with 10 or fewer reuses had significantly lower Kt/V(urea) at baseline (before the switch to citric acid dialysate) than those with > 10 reuses (1.23 +/- 0.23 vs. 1.47 +/- 0.23, respectively, p = 0.009). The Kt/V(urea) increased to 1.41 +/- 0.31 after the switch in the low-reuse group but the increase did not reach statistical significance (p = 0.07). The results from this study show that citric acid-containing dialysate is associated with increase in dialyzer reuse and appears to be related to reduced clotting.
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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 | 0.000 | 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) | 0.002 | 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".