The KIDNEY-CAP: A Novel Device in the Management of Bleeding in Intermittent Hemodialysis Patients
Bibliographic record
Abstract
Background: Out of hospital arteriovenous graft (AVG) and arteriovenous fistula (AVF) bleeding occurs in 1-3/1000 hemodialysis patients per year. It is associated with hospitalization, hemorrhagic shock, and death. Presently there are no approved out of hospital devices available to aid patients if they develop an out of hospital bleed. The KIDNEY-CAP is a 3D printed cap that has been developed for patient use in this scenario. This study assessed attitudes towards vascular access, transplantation, and home dialysis in nephrology health care workers (NHCs) such as nephrologists, nephrology nurse practitioners, and body access coordinators, as well as ESKD patients on hemodialysis (ESKD-D) and how the KIDNEY-CAP influences these impressions. Methods: Survey 1 studied KIDNEY-CAP introduction into the CKD/ESKD patient experience, and how it would impact NHC recommendations for kidney care. Parameters such as recommendation for transplantation, vascular access modality, and home dialysis opportunities were explored. In survey 2, in-center ESKD-D patients were evaluated for how the KIDNEY-CAP might modify decisions regarding their end stage kidney disease care. When survey respondents already had an AVG/AVF, their level of concern regarding AVG/AVF bleeding was quantified, while evaluating for common bleeding risk factors. Results: In survey 1, 41% of respondents indicated that they were more likely to recommend home dialysis and vascular access with AVG/AVF if a KIDNEY-CAP was available. Providers were more likely to recommend these options in patients not yet on dialysis. In survey 2, 66% of patients indicated at least slight concern about bleeding from their access site. 66% also felt they would benefit from having a device to help control bleeding outside the dialysis unit. 27.8% indicated that they would be more likely to select AVG/AVF as their vascular access of choice if they had a KIDNEY-CAP. There was no difference in feelings toward home dialysis or transplantation. Conclusion: We demonstrate that the KIDNEY-CAP is a device of interest for providers in determining vascular access for patients approaching dialysis. There may also be benefit to patient comfort with vascular access should the KIDNEY-CAP be available. Further exploration in the predialysis patient population is warranted, as is prospective study on the KIDNEY-CAP's adoption.
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 | 0.001 | 0.004 |
| 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 | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| 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".