Hypertension aggregates only in families of kidney stone patients with combined hyperuricosuria and hypercalciuria
Bibliographic record
Abstract
Past studies identified an association between kidney stone disease (KSD) and hypertension (HTN). We recently reported that the prevalence of a positive family history (Hx) of HTN, defined as 2 or more first-degree relatives with HTN, is significantly higher in patients with hyperuricosuric KSD and that hyperuricosuria is positively related to HTN occurring in the patients’ siblings. Because hypercalciuria is frequently found in KSD patients, in people at risk for HTN, and in hypertensives, we hypothesized that the changes in uric acid metabolism linking KSD to familial HTN may be related to increased urinary calcium (Ca) excretion. Study subjects were 212 consecutive KSD patients, aged 18–50 y, attending the lithotripsy unit. They collected a 24-h urine sample and provided a detailed family history of KSD and HTN. The association between the familial occurrence of HTN and urinary risk factors for KSD were assessed by logistic regression and the outcome variable was the presence or absence of positive family Hx of hypertension. Demographic data of 212 KSD patients: mean age 39.5 ± 7 (SD); men 68%; body mass index (BMI) 26.2 ± 5; personal Hx of HTN 10.9%; and family Hx of HTN 10.4%. Of the 42 patients with hyperuricosuria, 28.6% had an elevated urine Ca/creatinine ratio, designated the combined group, and the remainder were designated ‘pure’ hyperuricosuria. The prevalence of positive family Hx of HTN was 50% in the combined group compared to 10% in the pure group (p = 0.009). This comparison remained significant after adjustment for family size, age, BMI, and personal Hx of HTN in the proband. Moreover, the prevalence of positive family Hx of HTN in the ‘pure’ group was not different from that seen in the non-hyperuricosuric group. These data indicate that the increased prevalence of positive family Hx of HTN among hyperuricosuric KSD patients is due to the high prevalence of positive family Hx among the combined hyperuricosuric/hypercalciuric patients. This observation has important implications in selecting intermediate phenotypes for genetic studies in HTN.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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".