Differential Association of Body Mass Index with Access to Kidney Transplantation in Men and Women
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: Obese patients encounter barriers to medical care not encountered by lean patients, and inequities in access to care among obese patients may vary by sex. This study aimed to determine the association of body mass index (BMI) with access to kidney transplantation in men and women. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this retrospective analysis of 702,456 incident ESRD patients aged 18-70 years (captured in the US Renal Data System between 1995 and 2007), multivariate time-to-event analyses were used to determine the association of BMI with likelihood of transplantation from any donor source, transplantation from a living donor, and transplantation from a deceased donor, as well the individual steps in obtaining a deceased donor transplant (activation to the waiting list, and transplantation after wait-listing). RESULTS: Among women, a BMI ≥ 25.0 kg/m(2) was associated with a lower likelihood of transplantation from any donor source (hazard ratio [HR], 0.75; 95% confidence interval [95% CI], 0.73 to 0.77), transplantation from a living donor (HR, 0.75; 95% CI, 0.72 to 0.77), and transplantation from a deceased donor (HR, 0.74; 95% CI, 0.72 to 0.77). By contrast, among men, a BMI of 25.0-34.9 kg/m(2) was associated with a higher likelihood of the outcomes of transplantation from any donor source (HR, 1.08; 95% CI, 1.06 to 1.11), transplantation from a living donor (HR, 1.18; 95% CI, 1.13 to 1.22), and transplantation from a deceased donor (HR, 1.05; 95% CI, 1.02 to 1.07). Among men, the level beyond which BMI was associated with a lower likelihood of transplantation from any donor source or a living donor was ≥ 40.0 kg/m(2), and ≥ 35.0 kg/m(2) in the case of deceased donor transplantation. CONCLUSIONS: The association of BMI with access to transplantation varies between men and women. The reasons for this difference should be further studied.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".