Nephrocalcinosis and Renal Dysfunction in Pediatric Intestinal Failure
Bibliographic record
Abstract
Background: Outcomes of pediatric intestinal failure (PIF) have improved over the last decade, with other co-morbidities in long-term survivors now becoming evident. We recently reported on a large proportion of PIF patients with increased echogenicity/nephrocalcinosis on ultrasound (USS) in association with prolonged parenteral nutrition (PN) exposure[1]. The aim of our study was to evaluate the significance of nephrocalcinosis over time in PIF and its impact on renal function. Methods: A retrospective longitudinal analysis on a cohort of PIF patients previously described* by our program was performed. The presence of nephrocalcinosis and/or increased renal echogenicity (identified on USS), estimated glomerular filtration rate (eGFR in ml/min/1.73m2), PN volume (ml/kg/day) and exposure time (hours per day) were reviewed over a follow up period of 3 years. Outcomes in the nephrocalcinosis vs. normal USS groups were compared. Data was analyzed using medians and Mann–Whitney U test. Significance was established at p<0.05. Results: 40 patients out of 55 from the original cohort[1] (28 male, median age 2.7 yrs) were studied for 2 years; 24 of these 40 patients were also studied to 3 years. 15 patients (38%) had either increased echogenicity or nephrocalcinosis (Group 1) at initial USS. The USS were normal in the remaining 25 (62%) on initial assessment (Group 2). There was no difference in eGFR between group 1 and group 2 at baseline (118 vs 133, p=0.51), year 2 (130 vs 131, p-NS) & year 3 (130 vs 132, p-NS). There was no difference in PN volume between group 1 & 2 at baseline (114 vs 85, p=0.19), year 2 (82 vs 62, p-NS) & year 3 (62 vs 70, p-NS). There was also no difference in PN exposure time between group 1 & 2 at baseline (15 vs 14, p-NS), year 2 (11 vs 12, p-NS) & year 3 (13 vs 12, p-NS). Conclusion: A large proportion of PIF patients have nephrocalcinosis and/or increased echogenicity on USS while on prolonged PN exposure. However, in the short term the presence of these abnormalities has no impact on eGFR or PN parameters. Further long-term studies are required to evaluate the significance of these sonographic abnormalities over time. Reference: 1. Christina Kosar et al. Journal of Pediatric Surgery. 2016;51:794–797.
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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| 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".