Poor ultrafiltration shortly after peritoneal dialysis initiation
Bibliographic record
Abstract
(Section Editor: M. G. Zeier) Supported by an educational grant from A 63‐year‐old male with end‐stage renal disease due to nephroangiosclerosis started continuous ambulatory peritoneal dialysis on May 28, 2001 after 1 month of haemodialysis. A swan‐neck Missouri coiled peritoneal catheter had been inserted under general anaesthesia 12 days earlier without complication. The patient's medical history included long‐lasting elevated blood pressure, hypercholesterolaemia, a triple aorto‐coronary bypass together with aortic valve replacement in 1995, and atrial flutter since 1999. His maintenance therapy included warfarin, 1 mg or 2 mg o.d. on alternate days, calcium carbonate, 1 g t.d.s. and simvastatin, 20 mg o.d. Daily residual urine output was less than 500 ml. At the first peritoneal dialysis exchange, a 5‐cm fibrin clot was removed with the effluent (Figure 1). Next exchanges were clear. Four 2‐l exchanges were performed daily (1.36% glucose bag once, 2.27% glucose bag twice during the day‐time and one bag of icodextrin, during the night dwell, respectively). With this regimen, net ultrafiltration averaged 600 ml/24 h: ultrafiltration obtained with a 2.27% glucose bag was less than 250 ml while each icodextrin solution did not induce an ultrafiltration above 100 ml. After 48 h, the patient replaced, first, one of the 2.27% by a 3.86% glucose bag and secondly, the 1.36% glucose by a 2.27% glucose bag. Ultrafiltration over the next 3 days averaged 750 ml daily while patient's weight increased progressively from 81 to 83.5 kg. Clinical examination did not show peritoneal leaks. One session of sequential ultrafiltration was performed and allowed the removal of 4 l. Peritoneal dialysis was restarted with one 2.27% and two 3.86% glucose bags twice during the day‐time, and one icodextrin bag during the night dwell, without a significant improvement in ultrafiltration capacity (900 ml/day). After 4 days with this regimen, daily ultrafiltration was systematically insufficient to maintain the body weight below 82 kg.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| 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 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".