Predictors and Impact of Nephrocalcinosis in Renal Transplant Population: A Monocenter Retrospective Study
Bibliographic record
Abstract
Background: Persistence of bone and mineral anomalies in post-transplant population has been suggested as contributing factors to nephrocalcinosis (NC) that could lead to graft dysfunction. However, adequate characterization of calcium deposits in biopsies from renal transplant patients are lacking. We thus aimed to determine: 1) the prevalence of NC in renal transplant patients, 2) the factors associated with NC and 3) the impact of NC on renal graft function. Methods: This is a monocenter retrospective study using a protocolized renal biopsy from CHU de Québec, l'Hôtel-Dieu de Québec hospital from 2016-2018. All renal biopsies performed in 2016 at renal transplantation, at 6 and 24 months post-transplant were qualitatively and quantitatively analyzed for NC. Demographic, comorbidities and biochemistry parameters were collected from patients' records. Appropriate statistical analyses (Pearson's chi-squared, Wilcoxon-Mann-Whitney, Spearman's correlation and logistic regression) were performed to assess factors associated with NC and its impact on graft function. Results: We included 53 patients (mean age of 52±13 years, 55% of men, 94% with hypertension, 23% with peripheral arterial disease and 19% with prior parathyroidectomy). Forty-nine patients (92%) were on chronic dialysis treatment before transplant for a mean duration of 34±29 months. The presence of NC was observed in 14% at baseline, 37% at 6 months and 50% at 24 months. The severity of NC as assessed by the number of calcified foci in the tubulointerstitial compartment also tended to increase over time. Analyses showed that the presence of NC at 6 months was associated with male sex, presence of NC at baseline and high PTH levels (> 600 ng/L) at the time of transplant. Presence of NC at 24 months was also associated with prior NC and male sex. Interestingly, the presence of NC at 6 months was associated with use of phosphate supplements immediately after engraftment and with active vitamin D treatment at 6 months. Finally, NC at 24 months was correlated with the level of graft function as expected. Conclusions: This study reveals that uncontrolled mineral and bone metabolism parameters before renal transplant are associated with development of NC in the posttransplant period that may contribute to deterioration of renal graft function.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".