A Population-Based Assessment of Kidney Function and the Risk of Heart Failure Among Older Adults
Bibliographic record
Abstract
Background: Decreased kidney function (KF) increases the risk of heart failure (HF) and other adverse cardiovascular (CV) outcomes and death. However, the role of KF in this regard among old and very old adults is poorly understood. This is an important knowledge gap since the decline of KF in advanced age can affect both healthy and multimorbid individuals. Thus, our population-based study assessed whether decreased KF is associated with an increased risk of HF, CV and all-cause mortality in a prospective cohort of community-dwelling older adults. Methods: Participants of the Berlin Initiative Study (BIS), all aged ≥70 years, with baseline estimated glomerular filtration rate (eGFRBIS2) and no prior HF were followed from baseline (2009-2011) until the occurrence of a study outcome (hospitalization for HF [HHF], CV death, all-cause mortality) or 12/2020. HHF was defined via inpatient diagnostic codes, and mortality outcomes were defined via claims data, death certificates, and hospital discharge notes. Potential confounders included demographics, body mass index, alcohol consumption, smoking, physical exercise, education, income, comedications and comorbidities, measured at baseline using face-to-face interviews and claims data. Time-dependent Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) of the outcomes associated with decreased KF (eGFRBIS2 <60mL/min/1.73m2) compared with retained KF (eGFRBIS2 ≥60mL/min/1.73m2). eGFR values were updated biennialy. Results: Our cohort included 1466 HF free older adults (mean age 79 years; 55% female). Compared with retained KF, decreased KF was not associated with an increased risk of HHF (HR, 1.17; CI, 0.92-1.49), but was associated with increased risks of CV death (HR, 1.59; CI, 1.01-2.50), and all-cause mortality (HR, 1.33; CI, 1.02-1.72) (Figure). Conclusions: Our population-based study showed that decreased KF is associated with an increased risk of CV and all-cause death among older adults. The role of HF in this association seems to be limited. Funding: Private Foundation SupportRisk of outcomes with decreased KF among older adults
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 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".