In-Center Short Daily Dialysis and Children
Bibliographic record
Abstract
When faced with the realization that peritoneal dialysis (PD) is no longer feasible, what are the options for a 12 year old girl with End Stage Renal Disease, who also has Insulin Dependent Diabetes Mellitus? Recognizing that daily dialysis is the superior choice, how would In-Center Short Daily Hemodialysis (SDHD) impact this child? What are the risks for children? What are the benefits? Do we follow conventional guidelines? How would this impact her family as they were already facing burnout? There is significant evidence to support the improved outcomes for the adult dialysis patient on Short Daily/Nocturnal Dialysis. There is limited data available on outcomes for the pediatric hemodialysis population. After team and family meetings, SDHD, via permcath was initiated. To provide daily structure for the child, the diabetic regimen and minimize loss of school time, dialysis starts at 0730 hours. Kt/v, URR measurements and non-invasive blood monitoring continues. During the last eight months, better nutrition, diabetic control, no peritonitis, less phosphate binders, dietary and fluid restrictions, have resulted in increased school attendance, better performance and decreased hospitalization. BP control remains an issue. The family has arranged to have drivers on certain weekdays. The stress and workload is much less. Family time has improved. In conclusion, the bloodwork isn't always ideal and the BP is higher than we wish to see. Many questions still remain. However, the glow on her face as she describes getting to sleep in the top bunk, her latest sleepover and the “A” on her Math test has certainly influenced our decision to consider SDHD as the treatment of choice for our children requiring hemodialysis.
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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 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 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".