Evidence map›Paper›PMID 25477424›Full record

Trial reportAmerican journal of physiology. Regulatory, integrative and comparative physiology2015

Tetrahydrobiopterin lowers muscle sympathetic nerve activity and improves augmentation index in patients with chronic kidney disease.

Jeanie Park, Peizhou Liao, Salman Sher, Robert H Lyles, Don D Deveaux, Arshed A Quyyumi

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of physiology. Regulatory, integrative and comparative physiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
3.4field-weighted citation impact, top 7% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 27 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Trial
  4. Trial
  5. Review
  6. Article
  7. Review
  8. Article
  9. Neural control of cardiovascular function in black adults: implications for racial differences in autonomic regulation.American journal of physiology. Regulatory, integrative and comparative physiology · 2020
    Review
  10. Article
  11. Nutraceuticals as a potential adjunct therapy toward improving vascular health in CKD.American journal of physiology. Regulatory, integrative and comparative physiology · 2019
    Review
  12. Article
  13. Article
  14. Central Hemodynamics for Management of Arteriosclerotic Diseases.Journal of atherosclerosis and thrombosis · 2017
    Review
  15. Article
  16. Review
  17. Sympathetic control of reflex cutaneous vasoconstriction in human aging.Journal of applied physiology (Bethesda, Md. : 1985) · 2015
    Review
  18. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Jeanie ParkRenal Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; Research Service Line, Department of Veterans Affairs Medical Center, Decatur, Georgia; jeanie.park@emory.edu.
Peizhou LiaoDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia; and.
Salman SherCardiology Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Robert H LylesDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia; and.
Don D DeveauxRenal Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; Research Service Line, Department of Veterans Affairs Medical Center, Decatur, Georgia;
Arshed A QuyyumiCardiology Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Emory University · USVeterans Health Administration · US

Funding

CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR025008 · NCRR · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2007 to 2011
$29.0M
Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
The Role of Neurovascular Dysfunction and Oxidative Stress in the Exercise IntoleK23HL098744 · NHLBI · EMORY UNIVERSITY · PI PARK, JEANIE · 2010 to 2014
$668k
NCATS NIH HHS UL1 TR000454NCRR NIH HHS UL1 RR025008NHLBI NIH HHS K23 HL098744NHLBI NIH HHS K23HL-098744
6 · The paper itself

Abstract

Chronic kidney disease (CKD) is characterized by overactivation of the sympathetic nervous system (SNS) that contributes to cardiovascular risk. Decreased nitric oxide (NO) bioavailability is a major factor contributing to SNS overactivity in CKD, since reduced neuronal NO leads to increased central SNS activity. Tetrahydrobiopterin (BH4) is an essential cofactor for nitric oxide synthase that increases NO bioavailability in experimental models of CKD. We conducted a randomized, double-blinded, placebo-controlled trial testing the benefits of oral sapropterin dihydrochloride (6R-BH4, a synthetic form of BH4) in CKD. 36 patients with CKD and hypertension were randomized to 12 wk of 1) 200 mg 6R-BH4 twice daily + 1 mg folic acid once daily; vs. 2) placebo + folic acid. The primary endpoint was a change in resting muscle sympathetic nerve activity (MSNA). Secondary endpoints included arterial stiffness using pulse wave velocity (PWV) and augmentation index (AIx), endothelial function using brachial artery flow-mediated dilation and endothelial progenitor cells, endothelium-independent vasodilatation (EID), microalbuminuria, and blood pressure. We observed a significant reduction in MSNA after 12 wk of 6R-BH4 (-7.5 ± 2.1 bursts/min vs. +3.2 ± 1.3 bursts/min; P = 0.003). We also observed a significant improvement in AIx (by -5.8 ± 2.0% vs. +1.8 ± 1.7 in the placebo group, P = 0.007). EID increased significantly (by +2.0 ± 0.59%; P = 0.004) in the 6R-BH4 group, but there was no change in endothelial function. There was a trend toward a reduction in diastolic blood pressure by -4 ± 3 mmHg at 12 wk with 6R-BH4 (P = 0.055). 6R-BH4 treatment may have beneficial effects on SNS activity and central pulse wave reflections in hypertensive patients with CKD.

Indexed as

BiopterinsBlood PressureEndothelium, VascularFemaleHumansHypertensionMaleMiddle AgedMusclesNitric OxideNitric Oxide SynthasePulse Wave AnalysisRenal Insufficiency, ChronicRisk FactorsSympathetic Nervous SystemVascular StiffnessBiopterinsNitric OxideNitric Oxide Synthasesapropterinautonomic functionblood pressurenitric oxidesympathetic activityvascular stiffness

Identifiers

PMID25477424
PMCPMC4313073
OpenAlexW1990294083

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.