SynthesisJournal of the American Society of Nephrology : JASN2015
Assessing the Validity of Surrogate Outcomes for ESRD: A Meta-Analysis.
Synthesis in Journal of the American Society of Nephrology : JASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Guidelines for clinical evaluation of chronic kidney disease : AMED research on regulatory science of pharmaceuticals and medical devices.Clinical and experimental nephrology · 2018Guideline
- Effect of mineralocorticoid receptor antagonists on proteinuria and progression of chronic kidney disease: a systematic review and meta-analysis.BMC nephrology · 2016Pooled it
- Trial
- Heterogeneity of Estimated GFR Slopes According to Etiology, Estimated GFR and Urinary Albumin-to-Creatinine Ratio in a Large Cohort of Patients With CKD.Kidney international reports · 2026Article
- Article
- Surrogate endpoints in diabetic kidney disease: current perspectives and future directions.Frontiers in endocrinology · 2025Review
- An arterial spin labeling-based radiomics signature and machine learning for the prediction and detection of various stages of kidney damage due to diabetes.Frontiers in endocrinology · 2024Article
- The importance of addressing multiple risk markers in type 2 diabetes: Results from the LEADER and SUSTAIN 6 trials.Diabetes, obesity & metabolism · 2022Article
- Shrunken Pore Syndrome Is Associated with Renal Function Decline in Female Patients with Kidney Diseases.BioMed research international · 2022Article
- Combination of Changes in Estimated GFR and Albuminuria and the Risk of Major Clinical Outcomes.Clinical journal of the American Society of Nephrology : CJASN · 2019Observational
- Impact of Using Alternative Graft Function Endpoints: A Secondary Analysis of a Kidney Transplant Trial.Transplantation direct · 2019Article
- Cause-specific mortality in the general population with transient dipstick-proteinuria.PloS one · 2019Article
- Antihypertensive treatment and renal protection: Is there a J-curve relationship?Journal of clinical hypertension (Greenwich, Conn.) · 2018Review
- Urine Trefoil Factors as Prognostic Biomarkers in Chronic Kidney Disease.BioMed research international · 2018Article
- Article
- Albuminuria changes are associated with subsequent risk of end-stage renal disease and mortality.Kidney international · 2017Observational
- Relationship between eGFR Decline and Hard Outcomes after Kidney Transplants.Journal of the American Society of Nephrology : JASN · 2016Article
- Application of new acute kidney injury biomarkers in human randomized controlled trials.Kidney international · 2016Article
- Obesity, Renin-Angiotensin System Blockade and Risk of Adverse Renal Outcomes: A Population-Based Cohort Study.American journal of nephrology · 2016Article
- The Relationship between Renal Interstitial Vasculopathy and Clinical and Prognosis of Patients with Lupus Nephritis.Kidney diseases (Basel, Switzerland)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
Abstract
Validation of current and promising surrogate outcomes for ESRD in randomized controlled trials (RCTs) has been limited. We conducted a systematic review and meta-analysis of RCTs to further inform the ability of surrogate outcomes for ESRD to predict the efficacy of various interventions on ESRD. MEDLINE, EMBASE, and CENTRAL (from inception through September 2013) were searched. All RCTs in adults with proteinuria, diabetes, or CKD stages 1-4 or renal transplant recipients reporting ≥10 ESRD events and a surrogate outcome (change in proteinuria or doubling of serum creatinine [DSCR]) for ESRD during a ≥1-year follow-up were included. Two reviewers abstracted trial characteristics and outcome data independently. To assess the correlation between the surrogate outcomes and ESRD, we determined the treatment effect ratio (TER), defined as the ratio of the treatment effects on ESRD and the effects on the change in surrogate outcomes. TERs close to 1 indicate greater agreement between ESRD and the surrogate, and these ratios were pooled across interventions. We identified 27 trials (97,458 participants; 4187 participants with ESRD). Seven trials reported the effects on change in proteinuria and showed consistent effects for proteinuria and ESRD (TER, 0.82; 95% confidence interval, 0.59 to 1.16), with minimal heterogeneity. Twenty trials reported on DSCR. Treatment effects on DSCR were consistent with the effects on ESRD (TER, 0.98; 95% confidence interval, 0.85 to 1.14), with moderate heterogeneity. In conclusion, DSCR is generally a good surrogate for ESRD, whereas data on proteinuria were limited. Further assessment of the surrogacy of proteinuria using prospective RCTs is warranted.
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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.