Stress Is Very High in the Old Hemodialysis Patients and Accurately Predicts Their Outcome
Bibliographic record
Abstract
The mortality rate in dialysis is very high and extreme in older patients. The 10-year survival is less than 5% in those above 60 years. We thought the stress reaction accompanying dialysis may be particularly high in the older patients with their more fragile cardiovascular system. Methods: We measured ANP and NPY levels in 33 hemodialysis patients Mean age ± SD = 60 ± 11 years, and followed them for up to 12 years (Mean ± SD = 47 ± 45 months ). We created a stress-index by adding NPY × 3 to ANP levels. Results: Stress index Mean ± SD = 275 ± 152 ng/L. 18 patients died. In Cox proportional hazard analyses, the stress index was highly predictive of death, those with an index below mean had a RR of death of only 0.221, (CI. 0.076 + 0.664, p = 0.006) when compared to those with an index above mean. In stepwise analysis, the index was the only factor necessary to predict survival when run with 17 other variables. The stress index was correlated to age, Stress index = age × 5.3 + 43, ( p = 0.026). Patients above age 60 years had a stress index of 317 ± 143 compared to 218 ± 149 below age 60 (p = 0.063).. 50% of the old patients with a high stress index were dead at 22 months compared to 101 months for those with a low index. Att six years all patients above age 60 years and with a high stress index had died compared to 40% of those with a low index p = 0.025. Conclusion: Stress reaction to dialysis is the most important variable predicting death and is particularly high in the old. Present hemodialysis regimens are very stressful and unsuitable for many older patients and should be changed to daily, slow and longer treatment.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 |
| 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 | 0.001 | 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".