Nocturnal Home Hemodialysis Can Be Successful in Extremely Complicated Patients - A Case History.
Bibliographic record
Abstract
It has been well-documented that Nocturnal Home Hemodialysis (NHH) is a superior form of treatment for patients undergoing chronic renal replacement therapy. However, documentation as to the actual type of patient suitable to perform this treatment at home is scarce. Patients who have significant comorbities have routinely received their treatment in a supervised setting (in-hospital or limited care) which is a much more expensive modality. We believed these patients could successfully perform NHH and do so at less cost. The London Health Sciences Centre in London, Canada has recently completed a 3 year study utilizing matched cohort controls where patients have been treated with either Short Hour Daily Hemodialysis (SHDH) or NHH. Data collected includes biochemical, clinical and economical for 12 months retrospective on CH and 18 months on the selected daily therapy. Quality of Life data was obtained with disease specific questionnaires and the SF –36. Costs per Quality Adjusted Life Year was obtained with the Health Utilities Index tool. This case history of a very motivated 40 year old female with antiphospholipid antibody syndrome, bilateral amputation, uncontrolled hypertension and seizure disorder provides concrete data that not only has the cost of her health care diminished significantly (from $188,542.26 in the retrospective year to $80,249.76 Canadian dollars cost per patient year on NHH) but her Quality of Life has also dramatically improved. She was able to perform this treatment independently. Patients currently dialyzing in supervised settings should be carefully assessed to determine if they are suitable to perform NHH and thereby experience benefits derived from the therapy. Expensive dialysis in overcrowded hospital units could also be diminshed and coupled with the approaching nursing shortage all parties will benefit.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".