Biochemical and imaging alterations of renal bone disease in newly detected predialysis and on maintenance dialysis patients
Bibliographic record
Abstract
Objective: Bone involvement in chronic renal failure is manifested long before the initiation of dialysis and is more prevalent in patients receiving inadequate conservative phase management. This study aimed at identifying the extent of renal bone disease among pre‐dialysis and maintenance dialysis patients. Method: Thirty‐two patients (gr 1) on maintenance hemodialysis (HD) for variable period of time were compared to twenty newly detected, irregularly treated, (gr 2) pre‐dialysis severe renal failure patients for their clinical, biochemical, and imaging features. Result: Mean age of gr 1 and gr 2 patients was 45 ± 14 vs. 34 ± 15 years (p < 0.05). Comparison of blood biochemistry between group 1 and 2 showed serum creatinine 9.9 ± 2.9 vs. 13.4 ± 4.4 mg/dl (P < 0.01), calcium 10 ± 1.4 vs. 7.4 ± 1 mg/dl (p < 0.001); phosphate 4.4 ± 1 vs. 8 ± 2 mg/dl (p < 0.008); ionized calcium 4.7 ± 0.1 vs. 3.9 ± 0.7 mg/dl (p < 0.05); alkaline phosphatase 116 ± 31 vs. 86 ± 31 IU/l (p < 0.05); and iPTH 72 ± 48 vs. 147 ± 92 pg/ml (p < 0.05). Radiological changes present in the two groups were osteopenia‐63% vs. 65%(P = NS); trabecular resorption‐53% vs. 20%(p < 0.05); soft tissue calcification‐31% vs. 10%(p < 0.05); bone cyst‐16% vs. 25%(P = NS) and subperiosteal bone resorption‐16% vs. 20%(P = NS). Tc 99MDP bone scan combined in both groups of patients (n = 52) showed increased uptake in wrist joint (29%), tibia‐fibula (25%), costochondral junction, vertebral column (15% each), sternum (13%), radius and ulna (10%), and calvaria and mandible (8% each). X‐ray finding was positive for bone involvement in 59% cases and Tc 99 scan was positive in 80%(p < 0.05). Association study showed iPTH had a negative correlation with serum calcium (r = −0.5, p < 0.05) and a positive correlation with serum phosphate (r = 0.7, p < 0.05) and alkaline phosphatase (r = 0.9, p < 0.001). Conclusion: It is concluded that pre‐dialysis newly detected renal failure patients may present with deranged calcium homeostasis and can manifest high prevalence of bone involvement when compared to maintenance hemo‐dialysis patients.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".