FP151SODIUM POLYSTYRENE SULFONATE, PRACTICE PATTERNS AND ASSOCIATED ADVERSE EVENT RISK; A NATIONWIDE ANALYSIS FROM THE SWEDISH RENAL REGISTER
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
INTRODUCTION: Sodium polystyrene sulfonate (SPS) is licensed in Sweden for acute hyperkalemia treatment in patients with CKD, but also prescribed off-label for prevention. Despite long-standing clinical use, SPS practice patterns and associated adverse event risk remains unknown. METHODS: Observational study of all nephrologist-referred patients with CKD stage 3-5 initiating SPS in Sweden during 2007-2016. SPS users were 1:2 matched with non-SPS users (controls) and the following dispensation regimes were defined: isolated dispensation and chronic per label (45-60 g SPS/day), occasional (45 g/week) or sporadic (15 g/week) use. Cox proportional hazards evaluated the risk of adverse outcomes within 1 year, including severe (intestinal ischemia, thrombosis or ulceration/perforation) and minor (de novo dispensation of laxatives or anti-diarrheal drugs) gastrointestinal events. RESULTS: A total of 4723 CKD patients initiated SPS in Sweden and 90% of all users had stages 4,5 or underwent hemodialysis. Whereas 40% of SPS users only took one dispensation, 11%, 32% and 17% followed per label, occasional and sporadic chronic regimens, respectively. Compared to 9446 matched controls, SPS users were younger, more often men, with a previous history of hyperkalemia and consuming ACEi/ARBs (P<0.05 for all). During follow-up, 232 severe and 2302 minor gastrointestinal events were recorded. Compared to controls, SPS users did not experience an increased risk of severe adverse events (adjusted HR 1.18; 95% CI 0.89-1.56), but were at 1.24 (1.13-1.36) higher risk of minor gastrointestinal events, mainly accounted by de novo dispensation of laxatives (1.32; 1.20-1.46). Separate dispensation patterns showed similar results to the main analysis. CONCLUSIONS: In advanced/ESKD, SPS is often used chronically and below recommended dosages. SPS use did not associate with the risk of severe GI complications, but was associated with a 30% higher rate of laxative dispensations.
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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 | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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 it