MO301: The Incremental Chronic Kidney Disease Risk Among Post-Hospitalized Leptospirosis Patients With Acute Kidney Injury: Systematic Review And Meta-Analysis
Bibliographic record
Abstract
Abstract BACKGROUND AND AIMS Leptospirosis is a global zoonotic bacterial disease that may cause life-threatening complications, such as acute kidney injury (AKI). Patients with AKI may recover fully, but some can progress to chronic kidney disease (CKD) or even become dialysis-dependent. This study aims to evaluate the CKD and dialysis-dependent incidences and risks among post-hospitalized leptospirosis patients with AKI. METHOD Comprehensive searching was performed through the online databases of Pubmed, EMBASE, ScienceDirect and The Cochrane Library to include all relevant literature from 2000 to 2021. This study followed the PRISMA guidelines. The inclusion criteria are all observational studies that assess the incidence and risk for CKD development and dialysis dependence among post-hospitalized leptospirosis-associated AKI patients. The quality of included studies was accessed by using the Newcastle–Ottawa Scale. Analysis was conducted to obtain the pooled odds ratio (OR) with a 95% confidence interval (CI) with a fixed-effect heterogeneity test. RESULTS Five observational studies met the inclusion criteria. About 7%–14% of post-hospitalized leptospirosis patients with AKI deteriorate significantly to become CKD risk (pooled OR = 1.78, 95% confidence interval 1.41–2.23; P < .0001, I2 = 0%). A population cohort study suggested that Leptospira-seropositive population is correlated with the eGFR decline, even in the non-diabetic subgroup. Multivariate analysis from a cohort study showed that the elderly patients were predictors of dialysis-dependency and mortality. The funnel plot is symmetrical suggesting no publication bias. CONCLUSION Post-hospitalized leptospirosis with AKI patients has an incremental CKD risk. However, further studies are warranted to confirm the association and causality.
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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 | 0.011 | 0.032 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.040 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".