The Relationship between Calcium-phosphorus Metabolism Disorder and Cognitive Impairment in Maintenance Hemodialysis Patients
Bibliographic record
Abstract
ObjectiveTo explore the correlation between calcium-phosphorus metabolism disorders and the occurrence of mild cognitive impairment （MCI） in maintenance hemodialysis （MHD） patients and examine its value in predicting maintenance hemodialysis associated mild cognitive impairment （MHD-MCI）.MethodsFrom June 2020 to June 2021， 117 MHD patients were recruited from our blood purification center. Clinical profiles and laboratory parameters were recorded. Montreal Cognitive Assessment （MoCA） scale was utilized for evaluating overall cognitive function. They were divided into two groups of cognitive impairment and non-cognitive impairment. Correlations between MoCA scores and calcium and phosphorus metabolic variables were analyzed by Spearman's method. Logistic regression was utilized for examining the influencing factors of the occurrence of MHD-MCI. Receiver operating characteristic （ROC） curve was plotted for evaluating the value of potential risk factors in predicting MHD-MCI.ResultsAmong them， 71 patients developed MCI with an incidence rate of 60.7%. No statistical difference existed in the incidence of MHD-MCI in patients with different serum levels of calcium （Ca） and phosphorus （P）. With a rising serum level of iPTH/ALP （intact parathyroid hormone/alkaline phosphatase）， the incidence of MHD-MCI gradually increased. Spearman’s correlation analysis revealed that MoCA score was negatively correlated with serum level of iPTH/ALP. The correlation coefficients were -0.443 and -0.643 respectively and the difference was statistically significant （P<0.001）. Multivariate Logistic regression indicated that diabetes mellitus and serum level of ALP/iPTH were possible risk factors for MHD-MCI. ROC curve results implied that serum levels of iPTH and ALP had some value for judging MHD-MCI. Delong test showed that ALP was superior to iPTH in predicting MHD-MCI （Z=2.246， P=0.0153<0.05）.ConclusionThe incidence of MHD-MCI is 60.7%. Elevated serum levels of ALP and iPTH are independent risk factors for the occurrence of MHD-MCI. Serum ALP/iPTH has some value for predicting the occurrence of MHD-MCI and ALP may offer a better diagnostic performance.
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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 | 0.001 | 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".