Evidence map›Paper›PMID 25780780›Full record

ReviewPeerJ2015

Efficacy and safety of low molecular weight heparin compared to unfractionated heparin for chronic outpatient hemodialysis in end stage renal disease: systematic review and meta-analysis.

Ghanshyam Palamaner Subash Shantha, Anita Ashok Kumar, Mansha Sethi, Rohit C Khanna, Samir Bipin Pancholy

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in PeerJ, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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

13 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Anticoagulation for people receiving long-term haemodialysis.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Guideline
  3. Guideline
  4. Guideline
  5. Pooled it
  6. Review
  7. Article
  8. Article
  9. Article
  10. Observational
  11. Heparin Drug Shortage Conservation Strategies.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2019
    Article
  12. Article
  13. Heparin-Induced Thrombocytopenia in Chronic Hemodialysis Patients.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Review
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

5 authors.

Ghanshyam Palamaner Subash ShanthaThe Wright Center for Graduate Medical Education , Scranton, PA , USA ; The Johns Hopkins University, Bloomberg School of Public Health , Baltimore, MD , USA.
Anita Ashok KumarThe Wright Center for Graduate Medical Education , Scranton, PA , USA ; The Johns Hopkins University, Bloomberg School of Public Health , Baltimore, MD , USA.
Mansha SethiTemple University School of Medicine , Philadelphia, PA , USA.
Rohit C KhannaAllen Foster Research Centre for Community Eye Health, International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute , Hyderabad , India.
Samir Bipin PancholyDepartment of Medicine, The Commonwealth Medical College , Scranton, PA , USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background. Low molecular weight heparin (LMWH) is an effective anti-coagulant for thrombotic events. However, due to its predominant renal clearance, there are concerns that it might be associated with increased bleeding in patients with renal disease. Objectives. We systematically evaluated the efficacy and safety of LMWH compared to unfractionated heparin (UH) in end stage renal disease (ESRD) patients. Search Methods. Pubmed, Embase and cochrane central were searched for eligible citations. Selection Criteria. Randomized controlled trials, comparing LMWH and UH, involving adult (age > 18 years), ESRD patients receiving outpatient, chronic, intermittent hemodialysis were included. Data Collection and Analysis. Two independent reviewers performed independent data abstraction. I2 statistic was used to assess heterogeneity. Random effects model was used for meta-analysis. Results. Nineteen studies were included for systematic review and 4 were included for meta-analysis. There were no significant differences between LMWH and UFH for extracorporeal circuit thrombosis [risk ratio: 1 (95% CI [0.62-1.62])] and bleeding complications [risk ratio: 1.16 (95% CI [0.62-2.15])]. Conclusions. LMWH is as safe and effective as UFH. Considering the poor quality of studies included for the review, larger well conducted RCTs are required before conclusions can be drawn.

Indexed as

HemodialysisHeparinMeta-analysisThromboprophylaxis

Identifiers

PMID25780780
PMCPMC4359121

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Registered trials

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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.