Plasma Total Homocysteine Levels among Patients Undergoing Nocturnal versus Standard Hemodialysis
Bibliographic record
Abstract
Mild hyperhomocysteinemia, a putative risk factor for arteriosclerotic outcomes, is seen in >85% of hemodialysis patients. Therapeutic strategies, including pharmacologic-dose B vitamin supplementation and "high-flux" or "super-flux" hemodialysis, have consistently failed to normalize total homocysteine (tHcy) levels in these patients. Predialysis plasma tHcy levels in 23 patients who were undergoing nocturnal hemodialysis (NHD) six or seven nights/wk were compared with those in 31 patients from the same Canadian dialysis unit who were undergoing chronic standard hemodialysis (SHD) (all <65 yr of age, undergoing thrice-weekly treatments). The SHD patients were similar to typical North American chronic hemodialysis patients with respect to B vitamin status and albumin, creatinine, and tHcy levels. Geometric mean tHcy levels for the NHD patients were significantly lower (12.7 versus 20.0 microM, P < 0.0001), as was the prevalence of mild-to-moderate hyperhomocysteinemia (>12 microM; NHD, 57%; SHD, 94%; P = 0.002). Analysis of covariance adjusted for plasma folate, vitamin B12, and pyridoxal 5'-phosphate levels, age, and gender confirmed that NHD was independently associated with 6.0 microM lower geometric mean tHcy levels (P = 0.001). It is concluded that tHcy levels are significantly lower among NHD patients, compared with SHD patients. Clinical trials will be necessary to confirm that NHD is effective in reducing tHcy levels among patients with dialysis-dependent end-stage renal disease.
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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 | 0.001 | 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 | 0.000 | 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".