Systems-level health of patients living with end-stage kidney disease using standard lab values
Bibliographic record
Abstract
We present a systems-level analysis of end-stage kidney disease (ESKD) with a dynamical network analysis of 14 commonly measured blood-based biomarkers in patients undergoing regular haemodialysis. Utilizing a validated pipeline for declining homeostatic systems, our approach learns a dynamical model together with an invertible transformation that simplifies the behaviour of observed biomarkers into natural variables. Within the natural variables, we identified two distinct dynamical behaviours: (i) stochastic accumulation, the random accumulation of abnormal values, and (ii) mallostasis, a deterministic drift towards worse health. These behaviours are identified by persistent fluctuations indicating weak stability, or a gradual shift in homeostatic set point, respectively. Both lead to worsening natural variable values, making the natural variables salient survival predictors with preferred directions of increasing risk. When this worsening is transformed back into observable biomarkers, it generates a coherent spectrum of worsening medical signs characteristic of a medical syndrome. Specifically, we found that small modules of natural variables corresponded to two existing syndromes commonly afflicting ESKD patients: protein-energy wasting and sepsis. We also identified new prospective syndromes. Our findings suggest that natural variables are robust, systems-level biomarkers, capturing the complex, holistic changes in health associated with ESKD.
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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 | 0.004 |
| 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 | 0.001 | 0.001 |
| 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".