A case of secondary hyperparathyroidism in a patient on hemodialysis with parathormone levels within the targets and high total alkaline phosphatase
Bibliographic record
Abstract
Chronic kidney disease related mineral and bone disorders (CKD-MBD) cause significant morbidity and mortality. Guidelines for treatment and prevention of CKD-MBD have put focus on the treatment of secondary hyperparathyroidism in patients on hemodialysis by maintaining levels of parathormone (PTH) between 2 to 9 times the upper normal limit. However, levels of PTH are not always accurately correlated to the degree of bone remodeling, and some patients may suffer from hyperparathyroidism though their PTH levels are within the targets. Therefore, it is important to identify other bone markers that could help us adequately assess bone status in these patients, such as total alkaline phosphatase (TALP). In this case report, we describe a patient who suffered from poorly controlled hyperparathyroidism with very high levels of TALP despite having PTH levels within the targets. TALP could thus be an important bone marker and should be taken into consideration complementary to PTH when evaluating the bone status of a patient on dialysis.
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How this classification was reachedexpand
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 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".