Evidence map›Paper›PMID 19303683›Full record

Trial reportAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2009

Uric acid and long-term outcomes in CKD.

Magdalena Madero, Mark J Sarnak, Xuelei Wang, Tom Greene, Gerald J Beck, John W Kusek, Allan J Collins, Andrew S Levey, Vandana Menon

Registry-linked trialOpen access · bronzeAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04017806 (Study Protocol for a Prospective Observational Study Investigating the Role of Luminal Pressure on Arteriovenous Fistula Maturation), which is not on this map. Cited by 193 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
193citing papers in PubMed, 13 pooled it
11.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04017806 unknown statusnot on this mapstarted 2018, after this paper: background citation

Study Protocol for a Prospective Observational Study Investigating the Role of Luminal Pressure on Arteriovenous Fistula Maturation

TypeobservationalSponsorTaipei Medical University WanFang HospitalRan2018 to 2020Enrolled60ConditionsArteriovenous Fistula
3 · Its place in the literature

Who cites it

193 citing papers in PubMed, 13 syntheses or guidelines pooled it, 432 citations in OpenAlex.

  1. Education programmes for people with chronic kidney disease and diabetes.The Cochrane database of systematic reviews · 2024
    Pooled it
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  5. Low protein diets for non-diabetic adults with chronic kidney disease.The Cochrane database of systematic reviews · 2020
    Pooled it
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  10. Low protein diets for non-diabetic adults with chronic kidney disease.The Cochrane database of systematic reviews · 2018
    Pooled it
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  16. Vascular Function and Uric Acid-Lowering in Stage 3 CKD.Journal of the American Society of Nephrology : JASN · 2017
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133 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 2 countries.

Magdalena MaderoDepartment of Medicine, Division of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
Mark J Sarnak
Xuelei Wang
Tom Greene
Gerald J Beck
John W Kusek
Allan J Collins
Andrew S Levey
Vandana Menon
Tufts Medical Center · USCleveland Clinic · USHennepin County Medical Center · USInstituto Nacional de Cardiología · MXNational Institutes of Health · USUniversity of Utah · US

Funding

Novel Cardiac Risk Factors &Endothelial Function in CKDK23DK067303 · NIDDK · TUFTS MEDICAL CENTER · PI MENON, VANDANA · 2004 to 2008
$781k
CARDIOVASCULAR RISK FACTORS--CHRONIC RENAL INSUFFICIENCYK23DK002904 · NIDDK · TUFTS MEDICAL CENTER · PI SARNAK, MARK J · 2000 to 2004
$672k
MDRD LONG TERM FOLLOW UP STUDYU01DK035073 · NIDDK · CLEVELAND CLINIC FOUNDATION · PI BECK, GERALD J · 1986 to 2004
$650k
Chronic Kidney Disease, Vascular Disease and AgingK24DK078204 · NIDDK · TUFTS MEDICAL CENTER · PI SARNAK, MARK J · 2007 to 2011
$587k
NIDDK NIH HHS K23 DK002904NIDDK NIH HHS K23 DK02904NIDDK NIH HHS K23 DK067303NIDDK NIH HHS K24 DK078204NIDDK NIH HHS U01 DK035073NIDDK NIH HHS U01 DK35073
6 · The paper itself

Abstract

backgroundHyperuricemia is prevalent in patients with chronic kidney disease (CKD); however, data are limited about the relationship of uric acid levels with long-term outcomes in this patient population. STUDY

designCohort study. SETTING &

participantsThe Modification of Diet in Renal Disease (MDRD) Study was a randomized controlled trial (N = 840) conducted from 1989 to 1993 to examine the effects of strict blood pressure control and dietary protein restriction on progression of stages 3 to 4 CKD. This analysis included 838 patients. PREDICTOR: Uric acid level. OUTCOMES & MEASUREMENTS: The study evaluated the association of baseline uric acid levels with all-cause mortality, cardiovascular disease (CVD) mortality, and kidney failure.

resultsMean age was 52 +/- 12 (SD) years, glomerular filtration rate was 33 +/- 12 mL/min/1.73 m(2), and uric acid level was 7.63 +/- 1.66 mg/dL. During a median follow-up of 10 years, 208 (25%) participants died of any cause, 127 (15%) died of CVD, and 553 (66%) reached kidney failure. In multivariate models, the highest tertile of uric acid was associated with increased risk of all-cause mortality (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.07 to 2.32), a trend toward CVD mortality (HR, 1.47; 95% CI, 0.90 to 2.39), and no association with kidney failure (HR, 1.20; 95% CI, 0.95 to 1.51) compared with the lowest tertile. In continuous analyses, a 1-mg/dL greater uric acid level was associated with 17% increased risk of all-cause mortality (HR, 1.17; 95% CI, 1.05 to 1.30) and 16% increased risk of CVD mortality (HR, 1.16; 95% CI, 1.01 to 1.33), but was not associated with kidney failure (HR, 1.02; 95% CI, 0.97 to 1.07). LIMITATIONS: Primary analyses were based on a single measurement of uric acid. Results are generalizable primarily to relatively young white patients with predominantly nondiabetic CKD.

conclusionsIn patients with stages 3 to 4 CKD, hyperuricemia appears to be an independent risk factor for all-cause and CVD mortality, but not kidney failure.

Indexed as

Cardiovascular DiseasesCause of DeathConfidence IntervalsFemaleFollow-Up StudiesGlomerular Filtration RateHumansHyperuricemiaKidneyKidney Failure, ChronicMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateTime FactorsUric Acid

Identifiers

PMID19303683
PMCPMC2691553
OpenAlexW2012967253

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.