Total Nitrogen and Free Amino Acid Losses and Protein Calorie Malnutrition of Hemodialysis Patients: Do They Really Matter?’
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Bibliographic record
Abstract
BACKGROUND/AIMS: Protein calorie malnutrition (PCM) in patients on hemodialysis (HD) is multifactorial; however, HD per se induces nutrient losses. The aim of the present study was to characterize the losses of total nitrogen (TN) and free amino acids (FAs) through the dialysate and to determine the relationship between this loss and PCM, food ingestion, and the characteristics of the hemodialyzer in patients on HD. METHODS: In a prospective study, 21 patients submitted to low-flux HD 3 times a week were evaluated within a period of 6 months regarding nutritional status, dietary calorie and protein intake, and losses through the dialysate of TN, FA, and urea nitrogen (UN). The type, surface area and reuses (up to 12) of the dialysis membrane were determined on each occasion, and the adequacy of dialysis was estimated by Kt/V. RESULTS: 50% of the patients were considered malnourished, although the mean protein and energy intakes were similar for the malnourished and nourished patients. Mean TN losses through the dialysate were 16 g/session (60% UN). FA losses varied from 3.8 to 4.2 g/total volume. TN and FA in the dialysate did not differ significantly between malnourished and nourished patients. There was a positive correlation between membrane (polysulfone) area and TN (p <0.05) and ultrafiltrate volume and TN (p < 0.05), and a nonsignificant correlation between reuse of the dialysis membrane and TN. CONCLUSIONS: TN and FA losses through the dialysate were similar for malnourished and non-malnourished patients on chronic HD, thus they do not act as indicators of nutritional status impairment.
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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 | 0.001 | 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 | 0.000 |
| 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 it