AKI Perspectives and Practices in Latin America (LA) During COVID-19: Analysis from GlomCon Latin America Working Group
Bibliographic record
Abstract
Background: The epidemiology, clinical presentation, management and outcomes of COVID-19 comes from early reports from China and Europe with AKI prevalence ranging widely from 0.5% to 29%. However, knowledge about this pandemic is still emerging. With the epicenter now in the western hemisphere, we aim to determine the behavior and possible differences in presentation of AKI in COVID-19 patients in Latin America. To our knowledge, this is the first of such study. Methods: Descriptive analysis extracted from an online survey carried out among nephrologists, renal pathologists and other health workers treating kidney diseases between May 20-27, 2020 from sixteen Spanish speaking Latin American countries divided into 6 categories. We present the results for the AKI category. Results: 430 responses were obtained of which 360 (84%) were considered for analysis. 86% of the participants were nephrologists. 35% of the respondents reported the prevalence of AKI to be <5%, while 32% estimated it at 6-10%. The majority of AKI in these patients was stage 3 according to 31% of the respondents. Roughly half of the nephrologists witnessed new onset proteinuria which was almost exclusively (96%) subnephrotic. The majority (64%) reported no hematuria. Half of the participants (50.2%) reported that renal replacement therapy (RRT) was never or rarely required. Intermittent hemodialysis was the main RRT used reported by 88% of those surveyed followed by continuous renal replacement therapy (33%), peritoneal dialysis (24%) and prolonged intermittent RRT (19%). The most common complications during RRT were hypotension (60.3%) and circuit clotting (36.6%). Over one third of the participants (35%) estimated the mortality of patients with AKI and COVID to be <20%. Conclusions: Our survey highlights potential differences in the presentation, management and outcomes of AKI in patients with COVID-19 in LA; among those, a lower prevalence, higher need for RRT and lower mortality. More studies are warranted to better understand AKI in hispanic COVID-19 patients as well as its distinct characteristics compared to the rest of the world.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".