Unnecessary Renal Replacement Therapy for Acute Kidney Injury is Harmful for Renal Recovery
Bibliographic record
Abstract
The use of renal replacement therapy (RRT) for severe acute kidney injury (AKI) is frequently necessary in the face of life-threatening complications; however, there is wide practice variation with respect to triggers for RRT initiation. Recent evidence suggests that RRT may be independently associated with impaired recovery following AKI. There are plausible mechanistic reasons why RRT may be harmful and this concept is supported by ancillary evidence in the form of studies that have assessed the impact of different modalities of RRT for AKI as well as some of the literature pertaining to initiation of chronic hemodialysis in end-stage kidney disease patients (ESKD). As such, avoiding unnecessary RRT (URRT) is a desirable goal. There is emerging evidence of strategies that may be effective to help limit URRT. These strategies primarily involve early identification of AKI and limiting iatrogenic harm once AKI is established. Further research into defining and preventing URRT may help improve the consistently poor outcomes following severe AKI with respect to development of chronic kidney disease and ESKD.
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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 | 0.008 | 0.029 |
| Meta-epidemiology (narrow) | 0.005 | 0.002 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.005 | 0.002 |
| Research integrity | 0.018 | 0.030 |
| Insufficient payload (model declined to judge) | 0.005 | 0.006 |
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".