Hypertension (HT) and progression of renal disease in early chronic renal failure (CRF)
Bibliographic record
Abstract
Hypertension is a risk factor for the progression of renal disease, development of left ventricular hypertrophy (LVH), coronary artery disease and congestive heart failure. The purpose of this work was to review the frequency of HT and LVH in patients with early CRF referred to a pre-ESRD clinic and to follow the clinical course of the progression of their renal disease. Out of 150 adult patients referred to our pre-ESRD clinic 32 patients were identified with serum creatinines (SCr) between 2 to 3.4 mg/dL at their initial visit. There were 10 females and 22 males, their mean age was 56 yrs (range: 35–77) and the cause of the CRF was diabetes in 14, HT in 6 and primary renal disease in 12 patients. All the patients had HT (BP 140/90 or higher) and were on therapy for BP control. Only 4 patients were on single antihypertensive drugs and 28 were on combination therapy mostly ACE-inhibitors or ARBs in combination with diuretics and/or calcium channel blockers and/or alfa or beta-blockers and/or vasodilators. LVH was identified in 70% of cases. The minimum follow-up was 24 months and we compared blood pressure control with the number of months to doubling of the SCr. The mean (+1 SD) calculated (Gault-Cockcroft formula) creatinine clearance (CrCl) at the initial visit was 35 (±9) ml/min and the mean SCr was 2.6 (+0.3) mg/dL). There was a bimodal curve according to the time to doubling of SCr: 17 patients doubled their SCr in 23 ± 10 months, group I (G-I) and 15 patients (G-II) had a follow-up of 40 ± 14 months without doubling of their SCr. The mean systolic blood pressure (BP) in G-I was 148 (±18) mmHg VS 140 (±19) mmHg in G-II. The mean diastolic BP was 76 (±9) in G-I VS 77 (±9) in G-II. These results suggest that aggressive treatment for systolic HT is an ongoing need for patients with early CRF in order to slow down the progression of chronic renal disease. We suggest that in addition to microalbuminuria, CrCl should be part of the routine screening of hypertensive patients. Patients at risk should be identified and referred early in the course of their renal disease (CrCl < 60%) to pre-ESRD programs and their hypertension should be treated aggressively.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".