COMPARISON OF SURVIVAL AMONG OLDER ADULTS TREATED VERSUS NOT TREATED WITH CHRONIC DIALYSIS
Bibliographic record
Abstract
Background: Treatment options for older adults with kidney failure generally include chronic dialysis or non-dialysis (conservative) care. Previous comparisons of survival for dialysis and non-dialysis care patients have been limited to those referred to nephrology, with considerable differences in characteristics between those treated and not treated with dialysis. Objective: To compare time to all-cause mortality among older adults with kidney failure treated versus not treated with chronic dialysis. Methods: We conducted a population-based retrospective cohort study, using administrative and laboratory data to identify adults aged ≥65 in Alberta who experienced kidney failure from 2002 to 2012. Kidney failure was defined by ≥2 consecutive outpatient estimated glomerular filtration rate (eGFR) of <10ml/min/1.73m2 spanning a period of ≥90 days. The index date was the first eGFR that met the 90-day criteria. The exposure-outcome relationship was examined using Cox regression modelling with propensity score matching to account for baseline differences in demographics and comorbidities between treatment groups. Results: 838 patients met cohort inclusion criteria. 386 (46.1%) were included in the final propensity score matched cohort (mean age 80.2, 44.8% male, mean eGFR 7.8ml/min/1.73m2). 78.2% of adults in the non-dialysis group and 67.9% in the dialysis group died. The hazard ratio within 3 years of follow-up was 0.62 (95% CI 0.45–0.84), suggesting a potential survival benefit among those treated with dialysis. Conclusions: Among older adults with similar characteristics treated and not treated with chronic dialysis, dialysis may confer a survival benefit. These findings have important implications for informing clinical decision-making.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| 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".