PREDICTORS OF LONG-TERM RENAL DYSFUNCTION AND CHRONIC DIALYSIS AFTER HEART TRANSPLANTATION
Bibliographic record
Abstract
O338 Aim: To determine risk factors of renal dysfunction after heart transplantation (HTx). Methods: We reviewed 226 patients (pts) (189 men, 37 women, 51±10 yr-old) with HTx between July 1982 and August 2003 and who survived >1-mo. All the pts were on cyclosporine (CsA). Creatinine clearance (CrCl) was assessed with the Cockcroft-Gault formula. We evaluated sex, age, primary disease, diabetes, hypertension, ACE/ARB, CsA dose (mg/kg/day) and CsA trough levels at 1- and 3-mo. The data were recorded at baseline, 1-mo, 3-mo, 1-, 3-, 5-, 7-, 10-, 13-, 15-, 17- and 20-yrs post-HTx. Cox regression was done for time to chronic dialysis and for time until CrCl ≤30 ml/min ≥1-yr post-HTx. Results: The earliest time to chronic dialysis was 484 days. The strongest predictors of time to chronic dialysis were the drop in CrCl between 1-mo and 12-mo (Drop1-12), with an odds ratio (OR) of 1.35 per 10 ml/min of CrCl (95%CI (1.1-1.7), P=0.017, n=197, 13 events), or alternatively the drop in CrCl between 3-mo and 12-mo (Drop3-12), with OR 1.38 (95%CI (1.03-1.8), P=0.034). Both ORs are adjusted for systolic blood pressure (SBP) at 1-yr (SBP OR=1.44 per 10 mm Hg, P=0.031). The drop between 1-mo and 3-mo (Drop1-3) and pre-HTx CrCl, jointly predicted shorter time to CrCl ≤30 ml/min, with Drop1-3 OR 1.25 (95%CI (1.04-1.50), P=0.017; and pre-HTx CrCl OR 0.77 per 10 ml/min (95%CI (0.6-0.9), P=0.019 n=208, 23 events). Four factors jointly predict CrCl ≤30 ml/min at ≥3-yrs post-HTx: Drop1-12, with adjusted OR 1.23 (95%CI (1.0-1.5), P=0.045, n=197, 22 events), primary disease other than ischemic or dilated cardiomyopathy, with OR 3.3 (95%CI (1.1-10.0), P=0.03, CrCl at 1-yr, with OR of 0.64 per 10 ml/min (95%CI (0.5-0.9), P=0.005), and SBP, with OR 1.33 per 10 mm Hg (95%CI (1.04-1.7), P=0.024). Conclusions: DROP1-12 and Drop3-12 are strong predictors for earlier time to chronic dialysis. Drop1-12 is also predictive of CrCl ≤30 ml/min at ≥3-yrs post-HTx, along with CrCl and SBP at 1-yr, and primary disease other than ischemic or dilated cardiomyopathy. Finally, Drop1-3, along with baseline CrCl, predicts CrCl ≤30 ml/min at ≥1-yr post-HTx. These results suggest that future studies should focus on early kidney protection post-HTx.
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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 | 0.002 |
| 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 | 0.001 |
| 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".