FC 102: Daily Phosphorus Intake, its Source and Mortality in Adults on Hemodialysis: The Diet-Hd Study
Bibliographic record
Abstract
Abstract BACKGROUND AND AIMS Elevated serum phosphorus is associated with increased mortality in dialysis patients. Since the bioavailability of dietary phosphorus intake (DPI) varies based on its source and might contribute to serum phosphorus differently, the aim of the study is to investigate the association between total DPI and DPI from different sources with mortality in patients treated with hemodialysis. METHOD DPI (plant, animal and other sources) was ascertained by the Global Allergy and Asthma European Network food frequency questionnaire within the DIET-HD study, a multinational cohort study of European and South American adults on maintenance hemodialysis. Adjusted Cox regression analyses were conducted to evaluate the association between total and source-specific DPI (both as tertiles and continuous in fraction or in absolute amount) with all-cause and cardiovascular mortality. RESULTS A total of 8110 patients were followed for a median of 3.8 years (26 074 person-years). There were 2953 deaths, of which 1160 were cardiovascular-related. The median (interquartile range) DPI was 1388 (961–1994) mg/day, with only 12% (995/8110) of participants consuming the recommend range of DPI (800–1000 mg/day). Each standard deviation (SD, 896 mg/day) increase in total DPI was associated with higher all-cause mortality [hazard ratio (HR) 1.14; 95% confident interval (95% CI) 1.02–1.27] and cardiovascular mortality (1.45; 95% CI 1.08–1.96). Each SD (17%) increase in the fraction of DPI from plant sources was associated with lower all-cause mortality (HR 0.92; 95% CI 0.85–0.99) and marginally in cardiovascular mortality (HR 0.93; 95% CI 0.85–1.01). Each SD (9%) increase in the fraction of DPI from other source [HR: 1.06; 95%CI 1.02–1.10)] was associated with higher all-cause mortality. In contrast, each SD (17%) increase in the fraction of DPI from animal source was not associated either all-cause (HR: 1.02; 95% CI 0.96–1.07) or cardiovascular mortality (HR 1.07; 95% CI 0.98–1.16). Increased absolute amount of DPI from animal or other source were associated with both all-cause and cardiovascular mortality. CONCLUSION A higher total DPI is associated with increased all-cause and cardiovascular death. This positive association is driven by the DPI from animal and other sources, while higher DPI fraction from plant associated with reduced all-cause mortality.
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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 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".