A study of 8 hour long night dialysis with the Aksys PHD dialysis system
Bibliographic record
Abstract
The Aksys PHD system is designed for short quotidian dialysis employing a 52‐liter batch of ultrapure dialysate and up to 30 in situ hot water reuses of the entire extracorporeal circuit including a 40‐liter physical cleaning before each dialysis. Methods: We studied the effect of the 52‐liter tank during 108 long 5–8 hour dialysis 3.5–6 times/week in 5 patients and one 50‐liter patient simulator for 4 weeks. Phosphate (PO4), beta‐2 microglobulin (b‐2), urea (BUN), and creatinine (creat) were measured pre‐, during, and post‐dialysis 86 times and in total dialysate 74 times during long dialysis. Tank saturation, Kt/V, and monthly chemistries were also measured. Results: Patient weight 76 ± 2 kg, QB 234 ± 23 ml/min, QD 498 ± 13 ml/min. Dialysate was recirculated 4.8 times during 8 hours. Analyte Short Long dialysis p Pre‐BUN 70 ± 18 49 ± 15 <0.0001 Pre‐creat 12 ± 3 10 ± 2 <0.0002 Pre‐PO4 5.2 ± 1.5 4.1 ± 1.1 <0.003 Pre‐b‐2 34.0 ± 5.3 27.8 ± 4.5 <0.0001 All patients on 8 hrs × 5 dialyses/week stopped phosphate binders within 3 weeks. eKt/V(urea) rose to 0.5 in one hour and then slowly to 0.8 at 8 hours. Weekly stdKt/V: Dialyses/week/Hrs: 2 5 8 5 2.2 2.7 3.0 6 2.7 3.4 3.6 7 3.1 3.8 4.4 At 8 hrs the tank was 99 ± 8% saturated with BUN, 86 ± 12% with creat, 77 ± 18% with PO4, and only 12 ± 5% with b‐2. Total removal per dialysis increased 2 gm BUN, 0.4 gm creat, 0.4 gm PO4, and 40 mg b‐2. The decline per reuse in conductivity clearance was only 0.7 ± 1.2% during short and 1.4 ± 1.4% during long dialysis (p = 0.11). There was no change in monthly chemistries or hematologies. Discussion: The data show that the Aksys PHD is very effective for long 8‐hour dialysis. The data for PO4 and b‐2 are the same as reported for conventional dialysis machines using 5 times as much dialysate, and the weekly stdKt/V if the PHD is used every night is twice the standard defined by K/DOQI. The exceptional cleanliness and biocompatibility by way of the one‐per‐month reuse should be a great advantage to patients. The full automatization saves the patient one hour every night and 30 minutes every morning. The PHD also economizes on filters and dialysate and is good for the environment.
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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 | 0.001 | 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) | 0.001 | 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".