Evidence map›Paper›PMID 19828531›Full record

ArticleThe New England journal of medicine2009

Functional status of elderly adults before and after initiation of dialysis.

Manjula Kurella Tamura, Kenneth E Covinsky, Glenn M Chertow, Kristine Yaffe, C Seth Landefeld, Charles E McCulloch

2 registry-linked trialsOpen access · bronzeAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The New England journal of medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 412 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
412citing papers in PubMed, 11 pooled it
25.4field-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.

NCT02883309 approved for marketingnot on this mapstarted 2013, after this paper: background citation

Efficacy of an Intradialysis Combined Muscle Strength and Cardiorespiratory Capacity Training Program on Disability Level and Physical Performance, in Patients With Chronic Renal Failure at a Kidney Replacement Therapy Unit.

Typeexpanded_accessSponsorUniversidad Austral de ChileRan2013 to 2014ConditionsChronic Renal FailureArmsintradialytic physical training program
NCT07377500 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Randomised Controlled Trial of Dialysate Cooling for the Preservation of Cognitive Function in People Receiving Haemodialysis

TypeinterventionalSponsorUniversity Hospitals of Derby and Burton NHS Foundation TrustRan2026 to 2028Enrolled356ConditionsHaemodialysis, Kidney FailureArmsDialysis cooling
3 · Its place in the literature

Who cites it

412 citing papers in PubMed, 11 syntheses or guidelines pooled it, 1,026 citations in OpenAlex.

  1. ASN Kidney Health Guidance on Conservative Management in People with Kidney Failure.Journal of the American Society of Nephrology : JASN · 2026
    Guideline
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  3. Pooled it
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  11. Guideline
  12. Occupational Priorities of People on Hemodialysis Who Participated in Energy Management Education.Canadian journal of occupational therapy. Revue canadienne d'ergotherapie · 2025
    Trial
  13. The effect of micro-particle curcumin on chronic kidney disease progression: the MPAC-CKD randomized clinical trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023
    Trial
  14. Trial
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  18. Review
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  20. Ten tips for the first hemodialysis sessions.Clinical kidney journal · 2026
    Review

352 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Manjula Kurella TamuraDivision of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA. mktamura@stanford.edu
Kenneth E Covinsky
Glenn M Chertow
Kristine Yaffe
C Seth Landefeld
Charles E McCulloch
University of California, San Francisco · USSan Francisco VA Medical Center · USStanford University · US

Funding

CTSA: K12 COMPONENTKL2RR024130 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$19.3M
Midcareer Mentoring Award for Patient-Oriented Research in AgingK24AG029812 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COVINSKY, KENNETH E. · 2007 to 2017
$1.8M
Mechanisms of Cognitive Impairment in Chronic Kidney DiseaseK23AG028952 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KURELLA TAMURA, MANJULA · 2007 to 2011
$860k
NCRR NIH HHS KL2 RR024130NCRR NIH HHS KL2RR024130NIA NIH HHS K23 AG028952NIA NIH HHS K23AG028952NIA NIH HHS K24 AG029812NIDDK NIH HHS N01DK12450
6 · The paper itself

Abstract

backgroundIt is unclear whether functional status before dialysis is maintained after the initiation of this therapy in elderly patients with end-stage renal disease (ESRD).

methodsUsing a national registry of patients undergoing dialysis, which was linked to a national registry of nursing home residents, we identified all 3702 nursing home residents in the United States who were starting treatment with dialysis between June 1998 and October 2000 and for whom at least one measurement of functional status was available before the initiation of dialysis. Functional status was measured by assessing the degree of dependence in seven activities of daily living (on the Minimum Data Set-Activities of Daily Living [MDS-ADL] scale of 0 to 28 points, with higher scores indicating greater functional difficulty).

resultsThe median MDS-ADL score increased from 12 during the 3 months before the initiation of dialysis to 16 during the 3 months after the initiation of dialysis. Three months after the initiation of dialysis, functional status had been maintained in 39% of nursing home residents, but by 12 months after the initiation of dialysis, 58% had died and predialysis functional status had been maintained in only 13%. In a random-effects model, the initiation of dialysis was associated with a sharp decline in functional status, indicated by an increase of 2.8 points in the MDS-ADL score (95% confidence interval [CI], 2.5 to 3.0); this decline was independent of age, sex, race, and functional-status trajectory before the initiation of dialysis. The decline in functional status associated with the initiation of dialysis remained substantial (1.7 points; 95% CI, 1.4 to 2.1), even after adjustment for the presence or absence of an accelerated functional decline during the 3-month period before the initiation of dialysis.

conclusionsAmong nursing home residents with ESRD, the initiation of dialysis is associated with a substantial and sustained decline in functional status.

Indexed as

Activities of Daily LivingRenal DialysisAgedAged, 80 and overAge FactorsFemaleHumansKidney Failure, ChronicMaleNursing HomesTreatment Outcome

Identifiers

PMID19828531
PMCPMC2789552
OpenAlexW2169328204

What OpenQuestion holds

Textmetadata
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Read underepoch 390

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.