Kidney replacement therapy trajectories of patients with kidney failure: an ERA Registry study
Bibliographic record
Abstract
BACKGROUND: Trajectories of patients receiving kidney replacement therapy (KRT), including transitions between hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation (KTx), may vary across patient subgroups and have not yet been investigated in Europe. This study aimed to: (i) describe the number of shifts across KRT modalities; and (ii) characterize the most frequent patient trajectories, including the direction of shifts across KRT modalities, the duration spent on each modality, and patient events, including death. METHODS: Data of adult patients (≥20 years) who initiated KRT between 2004 and 2013 were extracted from the European Renal Association (ERA) Registry database and patients were followed for 10 years from the moment of KRT initiation. Results were stratified by age, sex, primary renal disease (PRD), country and initial KRT modality. RESULTS: Among 289 323 patients, more than two-thirds (69.6%) remained on their initial KRT modality until death or the end of 10 years follow-up, but younger patients and patients who initiated with PD had more shifts across KRT modalities than others. Overall, the most frequent patient trajectories were HD followed by death (53.4%), HD to KTx (10.2%), remaining on HD for 10 years (5.6%), PD followed by death (4.4%) and PD to KTx (2.9%). The most frequent patient trajectories differed between age and PRD groups, and across European countries, but not between women and men. CONCLUSION: The number and direction of shifts across KRT modalities varied by age, PRD, country and initial KRT modality, but not by sex. Future research should further investigate trajectories of patient subgroups that stood out, including young HD patients who died on their initial KRT modality and those who remained on HD for 10 years without undergoing KTx.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 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".