Bariatric surgery as bridging therapy to kidney transplantation
Bibliographic record
Abstract
Abstract The prevalence of obesity in adolescents is rising, including in those with kidney failure. Obesity increases the risk of complications during dialysis and may be associated with poorer outcomes after transplantation. Bariatric surgery has been found safe and effective in adults on dialysis. This Clinical Insights is about a 14-year-old female with kidney failure and obesity. She was initially managed on peritoneal dialysis but subsequently gained further weight. Multiple interventions for weight loss were unsuccessful, including the switch to haemodialysis. The patient underwent laparoscopic sleeve gastrectomy after extensive multidisciplinary assessment. She lost > 30 kg over 6 months (BMI decreased from 48 to 32 kg/m2) which made it possible for her to be activated on the deceased donor kidney transplant waiting list. Managing weight gain in patients on peritoneal dialysis is important, especially in obese adolescents. Bariatric surgery should be considered early where morbid obesity is a major impediment to listing for kidney transplantation.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
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".