Baseline and Longitudinal Self-Reported Physical Function and Important Clinical Outcomes in CKD
Bibliographic record
Abstract
Background: Physical function is essential for independent living and good health. However, it’s evolution and association with important clinical outcomes is unknown among people with CKD. We aimed to describe self-reported physical function over time and its relationship to heart failure events, incident end-stage kidney disease (ESKD), and death in a CKD cohort. Methods: Using annual data from the prospective CRIC Study, we calculated the physical composite summary (PCS) score from the SF-12 survey, a validated summary measure of physical health (range, 0-100, higher scores indicate better function). Linear regression models were used to calculate yearly PCS change for each participant using annual PCS scores from baseline to year 3 visits. After the year 3 visit, Cox models were used to examine the association of baseline PCS score and yearly PCS change with incident heart failure, incident ESKD and death. We also assessed effect modification by age, sex, race, and eGFR groups. Results: Among 5,495 CRIC participants at baseline, mean age was 60 yrs, 42.7% were non-Hispanic Black, 51.5% had diabetes and mean eGFR was 48.1 ml/min/1.732. Median (IQR) follow up was 9.4 (7.6-16.8) yrs. Mean (SD) PCS yearly change in the first 3 yrs was -0.17 (3.99). Lower baseline PCS and declining PCS slope were associated with 20-29% increased risk of incident heart failure and death and declining PCS slope was associated with 11% increased risk of incident ESKD (Table). Interactions were found for PCS-12 slope decline between eGFR groups and incident heart failure (HR for eGFR ≥30: 1.21, 95% CI: 1.05-1.39; HR for eGFR <30: 0.82, 95% CI: 0.61-1.09), and between race groups and ESKD (HR for Non-Hispanic White group: 1.09, 95% CI: 0.91-1.31; HR for Non-Hispanic Black group: 0.99, 95% CI: 0.87-1.13; HR for Hispanic group: 1.45, 95% CI: 1.09-1.93). Conclusion: Baseline and longitudinal changes in self-reported physical function were associated with important clinical outcomes in CKD, highlighting the importance of monitoring self-reported physical function over time in CKD care to identify those at risk and who may benefit from early and targeted interventions. Funding: NIDDK Support
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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 | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".