Outcomes of Vascular Access Creation Prior to Dialysis: Building the Case for Early Referral
Bibliographic record
Abstract
A 2-year single institution experience of the successes and complications of arteriovenous fistula (AVF) creation before dialysis initiation is reported. Study cohort: all patients who underwent AVF creation before need for dialysis (AVF group, n = 125). "Control" group: all patients with a sustained glomerular filtration rate (GFR) 12 months in both groups and mean eGFR at creation (AVF group) was 12 ml/min. In the AVF group, 72% underwent a successful first AVF creation, 11% suffered AVF thrombosis, and 17% had a nonmaturing AVF before need for dialysis. Sixty-six percent (n = 23) of these latter patients underwent a second AVF creation and 48% were mature at dialysis initiation. During the study period, 70% (n = 88, AVF group) and 61% (n = 121, no AVF group) commenced dialysis. Impressively, 72% (n = 66) of the AVF group used a mature fistula as their first dialysis access. A snapshot of "access in use" at the 6-month mark of dialysis revealed the AVF group had a higher number of patients using an AVF (81% vs. 44%) and a lower number with catheters (19% vs. 56%, respectively, p = 0.001). In conclusion, the success rate of early AVF creation is reasonable and complications when identified can be remedied without the need for a catheter, thus ultimately maximizing the use of AVF in dialysis patients.
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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 | 0.003 | 0.024 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".