P1419U- SHAPED ASSOCIATION OF SERUM PARATHYROID HORMONE AND COGNITIVE DYSFUNCTION IN MAINTENANCE HAEMODIALYSIS PATIENTS
Bibliographic record
Abstract
Abstract Background and Aims Primary hyperparathyroidism (HPT) is linked with several cognitive and affective disorders in the general population that tend to improve following parathyroidectomy. Most end- stage renal disease (ESRD) patients treated with maintenance haemodialysis (MHD) have 2ry/3ry HPT encompassing a broad range of serum intact parathyroid hormone (S. iPTH) values. They commonly suffer some degree of cognitive dysfunction (CODY) that impairs medication adherence and quality of life. This CODY results from the interplay of multiple factors, including HPT. However, relative hypoparathyroidism may as well cause CODY in the setting of adynamic bone disease and increased cerebrovascular calcification. Therefore, the relationship between S. iPTH and CODY in MHD patients needs to be clearly characterized across the whole spectrum of iPTH values. Method Seventy two stable ESRD patients (39 males, median age 50y) treated with thrice weekly low flux MHD for > 6 months underwent Montreal cognitive assessment- basic version (MoCA-B) and pre-dialysis assessment of S. iPTH, vitamin D3, alkaline phosphatase, urea, creatinine, calcium, phosphorus and haemoglobin (Hb). Results CODY, defined by a MoCA-B score < 24/30, occurred in 37/72 (51%) patients. MoCA-B score had a statistically significant positive correlation with Hb level. A quadratic inverted U-shaped curve provided the best estimate for the relation between S. iPTH and MoCA-B score (P = 0.019, Figure). Among patients in the highest S. iPTH tertile, S. iPTH has a statistically significant negative linear correlation with MoCA-B score (r = - 0.565, P = 0.004). This correlation was attenuated but persisted after controlling for Hb level (r = - 0.516, P = 0.012). Conclusion Anaemia and HPT are important contributors to the high prevalence of CODY in MHD patients. Both markedly high and relatively low (still above normal) S. iPTH levels are associated with lower MoCA-B scores, indicating a U- shaped relation between S. iPTH and CODY. Contrary to other populations, some degree of mild (permissible) HPT is most compatible with near normal cognitive function in MHD patients. Our results emphasize the recommendation of avoiding overzealous suppression of PTH secretion in these 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 | 0.000 | 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 | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".