Long-Term Deterioration of Kidney Allograft Function
Bibliographic record
Abstract
Although long-term survival after kidney transplanta-tion is critically dependent on maintaining stable al-lograft function, few studies have examined renal al-lograft function over time. Using pooled data from 10 278 consecutive transplants at five centers, we cal-culated slopes of estimated glomerular filtration rates (eGFR) measured after 1, 6 and 12 months in 9515, 8861 and 7359 patients surviving ≥1, ≥6 and ≥12 months, respectively. Slopes of eGFR progressively di-minished for patients transplanted during 1984–1989, 1990–1993,1994–1998 and 1999–2002 (analysis of vari-ance p < 0.0001 and p = 0.1245 for slopes measured after 1 and 6 months, respectively). Slopes measured after 12 months were less in the most recent era: –2.2 ± 7.2 mL/min/1.73 m2/year, –2.3 ± 6.6 mL/min/1.73 m2/year, –2.4 ± 7.4 mL/min/1.73 m2/year and –1.4 ± 10.9 mL/min/1.73 m2/year, respectively, p = 0.0058. Slopes measured after 1, 6 and 12 months each were less for transplantations during 1999–2002, after adjusting for multiple transplantation characteristics (p < 0.0001). Similarly, in Cox proportional hazards analysis, the risk (95% CI) for a 25% reduction in eGFR was 0.92 (0.85–1.01), p = 0.0736 during 1990–1994; 0.94 (0.82–1.08), p = 0.4111 during 19951998 and 0.78 (0.64–0.95), p = 0.0110 during 1999–2002 (compared to 1984–1989). We conclude that the rate of decline in allograft function after kidney transplantation has improved, suggesting that stable, long-term function may be achievable. Although long-term survival after kidney transplanta-tion is critically dependent on maintaining stable al-lograft function, few studies have examined renal al-lograft function over time. Using pooled data from 10 278 consecutive transplants at five centers, we cal-culated slopes of estimated glomerular filtration rates (eGFR) measured after 1, 6 and 12 months in 9515, 8861 and 7359 patients surviving ≥1, ≥6 and ≥12 months, respectively. Slopes of eGFR progressively di-minished for patients transplanted during 1984–1989, 1990–1993,1994–1998 and 1999–2002 (analysis of vari-ance p < 0.0001 and p = 0.1245 for slopes measured after 1 and 6 months, respectively). Slopes measured after 12 months were less in the most recent era: –2.2 ± 7.2 mL/min/1.73 m2/year, –2.3 ± 6.6 mL/min/1.73 m2/year, –2.4 ± 7.4 mL/min/1.73 m2/year and –1.4 ± 10.9 mL/min/1.73 m2/year, respectively, p = 0.0058. Slopes measured after 1, 6 and 12 months each were less for transplantations during 1999–2002, after adjusting for multiple transplantation characteristics (p < 0.0001). Similarly, in Cox proportional hazards analysis, the risk (95% CI) for a 25% reduction in eGFR was 0.92 (0.85–1.01), p = 0.0736 during 1990–1994; 0.94 (0.82–1.08), p = 0.4111 during 19951998 and 0.78 (0.64–0.95), p = 0.0110 during 1999–2002 (compared to 1984–1989). We conclude that the rate of decline in allograft function after kidney transplantation has improved, suggesting that stable, long-term function may be achievable.
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How this classification was reachedexpand
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) | 0.000 | 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 | 0.000 |
| 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".