Bibliographic record
Abstract
The kidneys, through proximal tubular active uptake or pass-through of filtered phosphorus, regulate phosphorus homeostasis in healthy individuals. Hormones and factors that contribute to the kidney regulation of phosphorus include parathyroid hormone, 1,25-dihydroxyvitamin D (1,25(OH)2D), and fibroblast growth factor-23 (FGF-23). However, in patients with progressive chronic kidney disease (CKD), the normal homeostatic mechanisms are challenged as FGF-23 and parathyroid hormone rise and 1,25(OH)2D levels decline. Certainly, by late stage 4 CKD and into ESRD, most of these patients exhibit frank hyperphosphatemia and have secondary hyperparathyroidism, marked elevations of FGF-23, and 1,25(OH)2D deficiency. These changes in normal phosphate homeostasis lead in part to the manifestations of the entity known as CKD–mineral bone disorder (CKD-MBD) (1). Epidemiologic data have identified an association between the hyperphosphatemia of CKD-MBD and patient-based outcomes of vascular calcification, myocardial dysfunction, and mortality (2–5). The management of hyperphosphatemia is currently based on a combination of three measures: dietary phosphorus restriction, dialysis, and the use of phosphate binders. The importance of phosphorus in the poor patient outcomes associated with untreated CKD-MBD is supported by the evidence that reduction of serum phosphorus, through the use of dietary phosphorus binders, improves patient survival (6–8). Our supplement, which is based on a conference held in Montreal in September 2008, focuses on some of the prevailing controversies regarding dietary phosphorus binders, leading to our symposium theme: “Myths and Realities of Calcium in CKD.” Historically, hyperphosphatemia was first treated with aluminum-based dietary phosphate binders, for which aluminum hydroxide was widely …
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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 | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.035 | 0.009 |
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".