Results of improvement in adequacy of intermittent hemodialysis (IHD) in uremic patients
Bibliographic record
Abstract
Increasing number of uremic patients, who need IHD, is a great challenge for every society but especially for poor and developing countries. The aim of our study is to look if small (not very expensive) increase in IHD adequacy is able to improve standard medical parameters. In 40 patients, treated with IHD for 57.5 (1–185) months, Kt/V was monitored on‐line during the middle IHD session in the week, 4 times in each of 6 consecutive months. Measurements of Kt/V based on a conductivity method. In the first month of observation Kt/V was lower (1.09 ± 0.02, p < 0.0009) than in later months, in which Kt/V was ranging from 1.13 ± 0.04 to 1.17 ± 0.01. Blood morphology was estimated every month. At the beginning of study period, after 3 months, and at the end of studies, dry body mass, BMI, the blood pH and serum concentration of calcium, phosphate, intact PTH, total protein, albumin, cholesterol, iron, ferritin, urea, and creatinine were determined. The increase in Kt/V was accompanied by rising values of Hb (99.1 ± 16.6 → 105.1 ± 12.5 g/l, p = 0.022), Hct (31.6 ± 5.2 → 33.8 ± 3.6%, p = 0.004), MCV (95.9 ± 7.7 → 100.7 fl ± 5.7, p = 0.000), iron (58.2 ± 29.6 → 73.2 ± 27.8 μg/dl, p = 0.002), blood pH before (7.26 ± 0.04 → 7.41 ± 0.04, p = 0.000) and after (7.34 ± 0.05 → 7.48 ± 0.05, p = 0.000) IHD session as well as by decreasing values of PTH [918 (38–3500)→ 420 (15–4341) pg/ml, p = 0.036]. Statistically unchanged parameters included dry body mass (70.4 ± 15.6 → 70.9 ± 16.1 kg), BMI (28.21 ± 6.73 → 28.23 ± 6.79 kg/m2), serum concentration of total protein (69.1 ± 5.7 → 70.9 ± 4.8 g/l), phosphate (5.72 ± 1.50 → 5.39 ± 2.02 mg/dl), cholesterol (203 ± 49 → 191 ± 62 mg/dl) and ferritin (740 ± 558 → 632 ± 346 ng/dl) as well as WBC (8.60 ± 3.89 → 6.52 ± 1.50 K/nl) and PLT (251 ± 91 → 195 ± 60 K/nl). There were correlations between Kt/V and serum concentrations of phosphate (r = 0.370, p = 0.019), PTH (r = 0.314, p = 0.048), ferritin (r = 0.417, p = 0.007), Hb (r = −0.376, p = 0.017), and Hct (r = 0.374, p = −0.017). Our results indicate that even a small increase in IHD adequacy leads to beneficial changes in management of uremic patients (better response on erythropoietin, diminished laboratory features of secondary hyperparathyroidism, better iron utilization). Correlation between Kt/V and examined parameters indicate that higher IHD doses were provided to patients in more advanced uremic state. It may partially explain advantages observed with incremental IHD adequacy.
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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 | 0.003 |
| 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) | 0.001 | 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".