Abstract P507: Atherosclerosis Progression in Chronic Kidney Disease
Bibliographic record
Abstract
Cardiovascular risk is very high in CRF, but the underlying mechanisms are not well understood. Traditional cardiovascular risk factors (RF) do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical RF and mortality in ESRD. CRF studies found that statin therapy does not reduce CV events; these may be the results of “resistant atherosclerosis” observed in these patients. We investigated if carotid total plaque area (TPA) is increased at progressively lower creatinine clearance and whether or not TPA progression is increased in CRF patients not on dialysis. Methods: The Blossom DMO Argentina ethics committee approved the study and informed consent was obtained from each participant. We performed a cohort study in 201 patients with Normal Renal Function (NRF), Stage 2 and 3 CRF. Clinical, laboratory tests and TPA were determined at time 0 and after 1 year. TPA was measured using carotid ultrasonography. Renal function (eGFR) was determined by the MDRD equation. The Study population was divided into quartiles of eGFR. Results: 1 st Quartile, (51±1yo, eGFR 89±2 ml/min) had a blood pressure (BP) of 136±2/81±1 mmHg, BMI 31±1, Total Chol (tChol) 196±6 mg/dl, HbA1c 6.7±0.4% and had the lowest Chol 192±5 mg/dl, HbA1c 6.2±0.1% and TPA 47±6mm 2 ; 3 rd Quartile, (59±1yo, eGFR 63±1 ml/min) BP 133±2/82±1, tChol 192±5 mg/dl, HbA1c 6.2±0.1% and TPA 47±6mm 2 ; 4 th Quartile (60±2yo, eGFR 52±1 ml/min) BP 140±3/84±1, tChol 209±5 mg/dl, HbA1c 6.2±0.1% and TPA 76±11mm 2 . After one year, the 4 th Quartile had the most progression of TPA ( p < 0.005); it was not influenced by age, hypertension, smoking, dyslipidemia or diabetic status. Conclusions: In CRF, TPA increases as renal function decreases; its progression is not associated with traditional risk factors. Other mechanisms are responsible for the observed excess of cardiovascular disease in CKD. Determination of TPA should be used to measure effects of antiatherosclerotic therapy to decrease the enormous cardiovascular event rate observed in this population.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.029 | 0.006 |
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".