Use and Outcomes of Peritoneal Dialysis among Aboriginal People in Canada
Bibliographic record
Abstract
There has been a dramatic increase in the incidence of ESRD among Aboriginal people in North America. Although peritoneal dialysis (PD) seems to be the dialysis modality of choice for this often rural-dwelling population, few data exist to confirm this. This study was conducted to evaluate rates of PD use, technique failure, and mortality among incident Aboriginal dialysis patients. Adults of white or Aboriginal race who initiated dialysis in three Canadian provinces between January 1, 1990, and December 31, 2000, were included and followed until December 31, 2001. Logistic regression and Cox proportional hazards models were used to examine adjusted associations between Aboriginal race and PD use, technique failure, and mortality. Among the 3823 patients of white (n = 3138; 82.1%) or Aboriginal (n = 685; 17.9%) race, 835 (21.8%) initiated dialysis on PD. After adjustment for age and comorbidity and comparison with white patients, Aboriginal patients were significantly less likely to initiate therapy on PD compared with white patients (odds ratio, 0.51; 95% confidence interval, 0.40 to 0.65), with a nonsignificant trend toward a higher risk for technique failure (hazards ratio, 1.46; 95% confidence interval, 0.95 to 2.23). Adjusted survival among Aboriginal PD patients seemed similar to both white PD patients and Aboriginal patients who were treated with hemodialysis. In summary, among people who were treated with dialysis in Canada, PD was used less frequently in Aboriginal patients than in those of white race. Although Aboriginal patients who initiate dialysis on PD seemed more likely to experience technique failure, their adjusted risk for death was similar to that of white patients. Future studies should address barriers to the initiation and maintenance of PD in the Aboriginal population, especially those who reside in rural locations.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".