Acute renal failure and chronic lymphocytic leukaemia
Bibliographic record
Abstract
Sir, Renal infiltration is often associated with chronic lymphocytic leukaemia (CLL). However, it is infrequently the direct cause of kidney failure. In CLL, post-renal obstruction with intra-abdominal [1–5] lymphadenopathy and/or increased incidence of uric stones, Bence–Jones proteinuria and/or cryoglobulinaemia can cause kidney failure indirectly [1,5]. A 69-year-old man with a 2-year history of lymphoma had CT thorax/abdomen/pelvis from 2 years prior to our evaluation that revealed extensive lymphadenopathy consistent with a diagnosis of CLL. The patient had no known drug allergies and was not on medications. The patient had had a kidney biopsy 1 year prior to our evaluation that revealed severe tubulointerstitial nephritis and mild interstitial fibrosis. His creatinine had progressed from 214 to 279 over 6 months, until 3 months prior to this presentation. At this time, he presented with dysphagia, without haematemesis, fever or diarrhoea and his serum creatinine was noted to be greater than 900 mmol/l.
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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 | 0.004 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.004 |
| Scholarly communication | 0.003 | 0.006 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.045 | 0.032 |
| Insufficient payload (model declined to judge) | 0.005 | 0.003 |
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".