Prevalence and Persistence of CKD and Hypertension 36 Months Post-Cisplatin in Children
Bibliographic record
Abstract
Background: Long-term kidney outcomes in children treated with Cisplatin(CisP) are unclear. We 1) estimated low eGFR and elevated BP or hypertension(eBP-HT) prevalence 36 months(m) post- pediatric CisP therapy; 2) determined if a)AKI during CisP and b)3m and 12 m kidney and BP status were associated with 36m low eGFR and eBP-HT. Methods: 12 Canadian-site 36m prospective cohort study of CisP-treated children. Exposures: a) AKI during CisP therapy (KDIGO serum creatinine criteria); b) 3m and 12m low eGFR (<90ml/min/1.73m2) and eBP-HT. 36m outcomes: a) low eGFR; eBP-HTN. Univariate tests and logistic regression (odds ratios [OR], 95% CI) were used to evaluate exposure-outcome associations. Results: 101 participants (51.5% girls, median[IQR] age 4.4[2.4-9.2]) included. 36m post CisP: 16/85(18.8%) had low eGFR; 26/88(29.6%) had eBP-HT; 38/79 patients(48.1%) had low eGFR or eBP-HT. Table 1 shows characteristics by outcomes. AKI was associated with 36m composite low eGFR or eBP-HTN (AKI: 23/38[60.5%]; no AKI: 15/38[39.5%], p<0.05). Low eGFR at 3m and 12m post-CisP were associated with 36m low eGFR (OR[95% CI]: 17.5[1.7-183]; 16[1.5-167], respectively, Table 1). 12m eBP-HT was associated with 36m eBP-HT (OR [95% CI] 4[1.4-11.8], Table 1). 12m low eGFR or eBP-HT was associated with 36m low eGFR or eBP-HT (OR [95% CI] 3.0 [1.1-8.3]). Table 1. - Characteristics by low eGFR and by eBP-HT status at 36 months post CisP therapy Low eGFR eBP or HT No [69 (81.2)] Yes [16 (18.8)] No [62 (70.4)] Yes [26 (29.6)] Patient, cancer and AKI Characteristics Female 32 (46.4) 11 (68.7) 31 (50.0) 13 (50.0) Age at chemotherapy start 3.9 (2.3-8.2) 5.5 (2.7-13.4) 5.1 (2.9-9.8) 3.3 (2.1-6.8) Caucasian 53 (76.8) 13 (81.3) 46 (74.2) 20 (76.9) Baseline eGFR (mL/min/1.73m2) 143 (115-171)* 118.5 (91.8-144.5) 132.9 (109-157) 160 (135-177)* Nephrotoxic medications* 8 (11.6) 1 (6.3) 5 (8.1) 2 (7.7) Cancer Type Osteosarcoma 10 (14.5) 1 (6.3) 11 (17.7) 1 (3.9) Germ cell tumor 8 (11.6) 3 (18.8) 7 (11.3) 2 (7.7) Neuroblastoma 28 (40.6) 3 (18.8) 18 (29) 12 (46.2) CNS Tumor 17 (24.6) 7 (43.8) 21 (33.9) 8 (30.8) Hepatoblastoma 5 (7.3) 2 (12.5) 4 (6.5) 3 (11.5) Other 1 (1.5) 0 (0) 1 (1.6) 0 (0) Total cisplatin dose (mg/m2) 383 (254.1-410.5) 403.5 (300.1-498.8) 385.9 (273.6-465) 395.1 (266.4-409.6) Acute Kidney Injury Types: Any AKI and Severe (Stage 2 or worse) AKI AKI during therapy 29 (42) 10 (62.5) 24 (38.7) 15 (57.7) Severe AKI 8 (11.6) 3 (18.8) 7 (11.3) 5 (19.2) 3 and 12 month low eGFR and presence of eBP or HT Low eGFR at 3 months 1 (1.5) 3 (21.4) eBP or HT at 3 months 12 (22.6) 7 (31.8) Low eGFR at 12 months 1 (1.5) 3 (20) eBP or HT at 12 months 10 (17.2) 10 (45.5) * p-value <0.05; ** p-value<0.01; # In the month prior to the 36 months' follow-up visit. Continuous variables expressed as median [interquartile range]; categorical variables expressed as numbers (proportion of total). Conclusions: Low eGFR and high BP are common after CisP and persist from 3m and 12m to 36m. Clear post-CisP kidney health follow-up guidelines must be developed. AKI during therapy may portend worse long-term CisP kidney health.
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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 | 0.001 |
| 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".