Survival Sex Differences among Pediatric and Young Adult Hemodialysis Patients in the Global MONDO Registry
Bibliographic record
Abstract
Background: For all age groups, women with ESKD on HD have higher rates of cardiovascular (CV) events compared to men, but their all-cause mortality is reduced. Survival in pediatric and young adult HD patients (pts) from across the globe is understudied. Methods: In this retrospective cohort study, we included all the ptsaged from 0-40 and treated with HD from the global MONDO database (2000 - 2012). Primary cause of ESKD were identified at dialysis initiation. Kaplan-Meier estimate was used to study the survival of male versus female in all age group and each of the age group (0- ≤12, >12-≤18, >18-≤26, >26-≤33, and >33-40) separately. Results: Of the 21,450 pts, 8,765 (40.9%) were females. Totally, 398,1.9% were 0-≤12; 13,92 (6.5%) were >12-≤18; 4,657 (21.7%) were >18-≤26; 6,398 (29.8%) were >26-≤33; and 8,623 (40.2%) were >33-40. Etiology by condition included 23.9% glomerular disease, 6.5% congenital and acquired urinary diseases, 32.1% other diagnoses, and 37.5% unknown causes of ESKD. There were no difference of pts with CV comorbidity in male vs. females (13%vs.11%). Pts distribution by region included 26.5% from Asia, 41.3% from Europe, 27.7% from Latin America and 4.5% from the US. The median survival time in both sexes was 32 years. Overall, males had a slightly better survival (p=0.0022). Age-stratified survival analysis revealed that males had a better survival than females (P=0.1099) significantly better survival in the >18≤26 age cohort (P<0.0001); all other stratified age groups showed no difference. Conclusion: In the global MONDO Registry, of 0–40-year-old HD pts, only young adult males (>18≤26 years) had slightly better survival. Otherwise, there is no sex difference. In contrast to the existing literature for all age groups, we did not observe an inequity of survival in male HD pts<40 years old.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 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".