Incident isolated 1,25(OH)2D3 deficiency is more common than 25(OH)D deficiency in CKD
Bibliographic record
Abstract
INTRODUCTION: Vitamin D deficiencies are well described in general populations and in those with chronic kidney disease (CKD). Although serum 25(OH)D may be a good indicator of vitamin D status in healthy individuals, the hydroxylated product, 1,25(OH)(2)D, essential for important biological functions such as mineral metabolism, bone turnover, regulation of protein synthesis, cell differentiation and proliferation may be a more suitable indicator for individuals with CKD. METHODS: We report an observational prospective cohort study of the incidence after 12 months of new isolated 1,25(OH)(2)D and new 25(OH)D deficiency in CKD patients (estimated glomerular filtration rate [eGFR] <60 ml/min), who were vitamin D replete at baseline. All analyses were run in a central laboratory. RESULTS: Of 1,256 patients who completed the study at 12 months, 631 were replete in both 25(OH)D and 1,25(OH)(2)D at baseline; at 12 months, 65% remained replete, 25% developed an isolated 1,25(OH)(2)D deficiency, whereas only 6% developed an isolated 25(OH)D deficiency. Based on the multinomial logistic regression model, factors that were associated with 12-month changes in vitamin D status were diabetes, baseline values of eGFR, albumin and both 25(OH)D and 1,25(OH)(2)D (all p values <0.03). Patients with diabetes, lower albumin, lower eGFR, lower levels of 25(OH)D and 1,25(OH)(2)D at baseline were at increased risk of developing isolated 1,25(OH)(2)D deficiency. CONCLUSIONS: The high incidence of new isolated 1,25(OH)(2)D deficiency as compared with new 25(OH)D deficiency, in the presence of 25(OH)D sufficiency, brings into question the value of measuring 25(OH)D levels in CKD. The significance of these findings and implications for replacement strategies require further study.
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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) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".