Renal function in recipients of pancreas transplant alone
Why this work is in the frame
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Bibliographic record
Abstract
PURPOSE OF REVIEW: Pancreas transplant alone (PTA) has become an accepted therapy for selected nonuremic patients with type 1 diabetes mellitus. We report a literature review, as well as data from the McGill University pancreas transplant program. RECENT FINDINGS: The published literature suggests that there is reversibility of diabetic nephropathy when normoglycemia is maintained for 5-10 years after successful PTA. There is also evidence of development and progression of histological lesions compatible with calcineurin inhibitor nephrotoxicity, as well as a decline in renal function overtime, with an increased risk of end-stage renal disease (ESRD). We studied 43 patients with PTA. Nine patients had a pretransplant estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m, and 34 patients had an eGFR greater than 60 ml/min/1.73 m. The actuarial incidence of ESRD at 1, 3 and 5 years was 0, 28.57 and 61.9% in patients with pretransplant eGFR less than 60 ml/min/1.73 m, and 0, 8.2 and 12.5% in patients with pretransplant eGFR greater than 60 ml/min/1.73 m, respectively (P=0.006). Multivariate analysis confirmed that age, sex, duration of diabetes prior to PTA and eGFR pretransplant were significant predictors of ESRD. SUMMARY: The ideal management of candidates for PTA with eGFR less than 60 ml/min/1.73 m remains to be determined. Future studies should focus on determining potentially reversible predictive factors of progression to ESRD after PTA, as well as the outcomes of these patients on chronic dialysis.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.000 | 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 it