Comparative Study Between Hemodialysis and Hemodiafiltration Regarding Effect on Cognitive Function
Bibliographic record
Abstract
Objective: Cognitive impairment (CI) is very common in chronic kidney disease (CKD) and is strongly associated with increased mortality. Hemodiafiltration (HDF) is a dialysis modality that is thought to offer better clearance of middle molecules, more stability of intradialytic blood pressure and better cognitive state of end stage renal disease (ESRD) patients. So, we aim to compare cognitive function in hemodialysis (HD) versus HDF patients.Materials and Methods: In a cross sectional study, 100 patients were divided as: 50 patients maintained on HD 3 regular sessions per week, 50 patients maintained on 3 regular sessions of HDF per week. Patients with dementia or delirium, Patients with psychosis or bipolar disorder, Patients who are under the influence of a substance or alcohol, Patients with previous history of cerebrovascular stroke were excluded. History including demographic data, etiology of ESRD and comorbidities was taken. Cognitive assessment was done using Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). Blood samples were taken to measure kidney function tests, metabolic profile, complete blood count, thyroid and parathyroid function tests.Results: Cognitive assessment using MoCA showed that in HD group: 12 patients were found to have CI and 38 patients were normal, while in HDF group only 4 patients were found to have CI and the other 46 patients had normal cognitive function.Conclusions: Our study shows that the MoCA test is a valid screening test for CI in both HD patients and HDF patients. It demonstrated higher sensitivity for screening patients with mild CI than MMSE. CI is often under-diagnosed due to the patients’ unawareness of their cognitive deficits. Therefore, screening tests would be more appropriate for these patients. The MoCA test which is sensitive to executive dysfunction seems to be more adaptable to assess CI in both groups of this study; HD patients and HDF patients; HDF is a modality of dialysis with better outcome regarding cognitive function in ESRD patients.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| 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".