Cognitive Improvement in ESRD Patients After Renal Transplantation: A Prospective Observational Study
Bibliographic record
Abstract
Background: Although there is a well-established survival benefit of renal transplant, the evidence of its effect on cognitive function is limited and not entirely consistent. Up to 30 - 70 % of end stage renal disease patients are reported to have cognitive deficits. The etiology of cognitive impairment in chronic kidney disease patients is multifactorial. Kidney transplantation can correct the metabolic derangements and eliminate the fluid and osmotic shifts that patients can experience on dialysis; however, cognitive impairments still persist post-transplant. Further research is warranted to better understand the impact of kidney transplant on a wide array of cognitive domains. Methods: 100 patients, age between 18 to 60 years who underwent renal transplantation in Medanta Hospital, India were prospectively studied from September, 2021 to December 2022. The aim was to determine the proportion of patients showing cognitive improvement 3 months and 6 months post renal transplant using Montreal Cognitive Assessment (MoCA) and to find the cognitive domains which show significant improvement 3 months and 6 months post transplant. Results: Proportion of patients showing cognitive improvement 3 months and 6 months post transplant was 26% and 56%, respectively. The mean MoCA score (out of total of 30) at pre transplant, at 3 months and 6 months post-transplant was 24.08 ± 3.08, 24.32 ± 2.90 and 25.28 ± 3.05, respectively. Mean MoCA score after 6 months of transplant, when compared to the mean score at pre transplant level was found to be statistically significant (p value <0.001). Delayed recall showed significant improvement 3 months and 6 months post-transplant (p value- 0.016 and < 0.001 respectively). Conclusions: Significant cognitive improvement was seen 6 months post renal transplant. Delayed recall showed significant improvement 3 months and 6 months post transplant. - Montreal Cognitive assessment (MoCA) score Mean Difference Std. Error p value 95% Confidence Interval for Difference Lower Bound Upper Bound At 0 months At 3 months -0.24 0.105 0.071 -0.495 0.015 At 6 months -1.200 0.303 <.001 -1.938 -0.462 At 3 months At 6 months -.960 0.272 0.002 -1.622 -0.298
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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) | 0.000 | 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 teacher head, 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".