Aiming for the optimal bicarbonate prescription for maintenance hemodialysis therapy in end‐stage renal disease
Bibliographic record
Abstract
Abstract Introduction: Acidemia and alkalemia, as a result of gradual depletion of the body's buffers followed by rapid repletion during hemodialysis (HD), are linked to adverse consequences. We examined the acid‐base status with dialysis bath of higher bicarbonate (HC03−) concentration or standard HC03− bath plus oral HC03− supplementation. Methods: A total of 60 stable HD patients (pts) were evaluated according to their pre‐dialysis acid‐base status both before the first and the second session of the week dialyzed against standard base dialysate of 35 mmol/L. Those who presented predialysis HC03− <22 mmol/L (25 pts) were assigned to dialysis against bath of increased HC03− levels (37 mmol/L) for 2 weeks (period A) and subsequently to dialysis with the standard dialysate bath plus daily oral sodium bicarbonate at a dose of 5 g/day for 2 weeks (period B). Pre and post‐dialysis acid‐base status at each study period and relevant laboratory tests were recorded. Findings: Pre‐dialysis acid‐base values were similar between the first and the second dialysis session. Twenty‐five points had pre‐dialysis pH <7.35, while 42 (the younger ones) presented pre‐dialysis HC03− <22 mmol/L. After dialysis session 18 pts had pH >7.45. Comparing the two study periods, interdialytic weight was similar, pre‐dialysis HC03− levels were improved with oral bicarbonate, while post‐dialysis HC03− were higher during period A. Three pts could not tolerate the symptoms of alkalemia during period A. Discussion: The impact of conventional HC03− concentrations of 35 mmol/L results in a considerable degree of pre‐dialysis acidemia. Increasing the HC03− in bath results in more prominent post‐dialysis alkalemia, however, it is not sufficient to maintain acid‐base status during the interdialytic period. Oral bicarbonate supplement at a dose of 5 g/day (divided in three daily doses) results in a more balanced acid‐base status, avoiding post‐dialysis alkalemia.
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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 | 0.001 |
| 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".