Bibliographic record
Abstract
Introduction: PD catheter for ESRD is an elective procedure is done by surgeons, interventional radiologists (IR), or nephrologists. We describe a successful bedside PD catheter insertion and immediate initiation of PD in a uremic patient, with hypoxia, and hyperkalemia with no bowel preparation. Case Description: A 38-year-old patient with diabetic nephropathy was on 5/week HD for 5 years. He had failed multiple accesses for HD including temporary and tunneled catheters, AV grafts, trans-lumbar dialysis catheter. The accesses were complicated with CRBSIs, and central venous stenosis needing multiple interventions including angioplasties, and thrombolytics. He had inefficient HD and persistent pruritus, leading to the pulling of the HD catheter on multiple occasions. He was recently admitted with infective endocarditis, mitral regurgitation, and heart failure. His tunnelled internal jugular catheter was again dislodged. While waiting 2 days for a new HD catheter placement by IR, he developed uremia in the form of myoclonus, orthopnea, hypoxia needing Oxygen and refractory hyperkalemia. IR staff evaluated all the vascular accesses and concluded that no further HD CVC could be placed. A decision was taken to place a bedside PD catheter on an urgent basis. The bowel prep was given 3 hours before the procedure. The patient was hypoxic needing 6 lits of O2 and with 30° head elevation. Under mild sedation, using ultrasound, a midline supraumbilical coiled double-cuffed Tenchkoff PD catheter was inserted at the bedside by the nephrology team. After confirming good inflow and outflow, we were able to start the PD on the table itself with 4.25% dextrose PD solution and continued with low volume, supine, cycler PD with 4.25% solution. His UF was 1.3 lits in 24 hours. There were no complications like leak, bleeding or perforation. After a week, the patient was on room air, with no uremic features and electrolyte imbalances. His PD was continued with low volume cycler, supine PD. Discussion: Bedside PD catheter placement for the immediate start of PD is not commonly done. Our patient did not have any vascular access for HD and we had to do urgent PD catheter insertion and start PD immediately as life life-saving measure as he was getting uremic, hypoxic and hyperkalemic and with no bowel preparation. Fortunately, there was no PD leak in short-term follow-up.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.004 |
| Insufficient payload (model declined to judge) | 0.023 | 0.005 |
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".