Vascular Access Survival with Thrice-Weekly, In-Center, Nocturnal Haemodialysis
Bibliographic record
Abstract
Background: This study explores vascular access complications in patients established on in-centre nocturnal haemodialysis (INHD) compared to conventional haemodialysis. Methods: Retrospective cohort study with patients acting as their own control. Data were collected from: Leicester Renal Network, UK (project number 12494) and The Ottawa Hospital, Canada (project number 20230336-01H). Adults established on INHD (intervention period) preceded by usual daytime in-centre haemodialysis (control period) with an established vascular access were eligible. Data were collected between 01/01/2009-31/12/2021. The primary outcome measure was a composite of outcomes due to vascular access complication: hospitalisation, intervention, change in vascular access modality, change in dialysis modality and death. The primary outcome was evaluated by time-to-event rate in days using Kaplan-Meier plots. Statistical significance was accepted at P<0.05. Results: 123 individuals were included (UK, n=66; Canada, n=57). The mean age was 51.2 years (±17.0), 69.1% (n=85) were male, 56.1% (n=69) were white. There was no difference in the primary outcome for the intervention period (n=33, 26.8%) and the control period (n=31, 25.2%): P=0.868. The 12-month vascular access survival probability was 69.8% (95%CI 61.0–78.6%) for the intervention period and 70.5% (95%CI 61.5-79.5%) for the control period (Figure 1). During the intervention period, arteriovenous grafts were associated with lower vascular access survival (P<0.001), and during the control period, regular vitamin K antagonist use was associated with lower vascular access survival (P=0.002). Conclusion: Vascular access type and use of regular anticoagulation were associated with a reduced vascular access survival probability. There does not appear to be an increased risk to vascular access survival and safety for INHD compared to conventional haemodialysis.Figure 1 – Kaplan-Meier plot demonstrating vascular access time-to-event rate
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".