Evidence map›Paper›PMID 25944876›Full record

ArticleJournal of the American Heart Association2015

Volume overload and adverse outcomes in chronic kidney disease: clinical observational and animal studies.

Szu-Chun Hung, Yi-Shin Lai, Ko-Lin Kuo, Der-Cherng Tarng

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03923933 (Chlortalidone and Bumetanide in Advanced Chronic Kidney Disease), which is not on this map. Cited by 90 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 3 pooled it
8.4field-weighted citation impact, top 2% 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.

NCT03923933 phase2completednot on this mapstarted 2019, after this paper: background citation

Chlortalidone and Bumetanide in Advanced Chronic Kidney Disease: HEBE-CKD Trial

TypeinterventionalSponsorHospital General de México Dr. Eduardo LiceagaRan2019 to 2019Enrolled34ConditionsRenal Insufficiency, ChronicArmsChlorthalidone, Bumetanide
3 · Its place in the literature

Who cites it

90 citing papers in PubMed, 3 syntheses or guidelines pooled it, 156 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Observational
  6. Associations of Pre-Pandemic CKD With Acute and Post-Acute COVID-19: The C4R Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026
    Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Observational
  19. Article
  20. Article

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

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

4 authors at 4 institutions in 1 country.

Szu-Chun HungDivision of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan (S.C.H., K.L.K.) School of Medicine, Tzu Chi University, Hualien, Taiwan (S.C.H., K.L.K.).
Yi-Shin LaiInstitute of Physiology, National Yang-Ming University, Taipei, Taiwan (Y.S.L., D.C.T.).
Ko-Lin KuoDivision of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan (S.C.H., K.L.K.) School of Medicine, Tzu Chi University, Hualien, Taiwan (S.C.H., K.L.K.).
Der-Cherng TarngInstitute of Physiology, National Yang-Ming University, Taipei, Taiwan (Y.S.L., D.C.T.) Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (D.C.T.).
National Yang Ming Chiao Tung University · TWTaipei Tzu Chi Hospital · TWTaipei Veterans General Hospital · TWTzu Chi University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVolume overload is frequently encountered and is associated with cardiovascular risk factors in patients with chronic kidney disease (CKD). However, the relationship between volume overload and adverse outcomes in CKD is not fully understood. METHODS AND

resultsA prospective cohort of 338 patients with stage 3 to 5 CKD was followed for a median of 2.1 years. The study participants were stratified by the presence or absence of volume overload, defined as an overhydration index assessed by bioimpedance spectroscopy exceeding 7%, the 90th percentile for the healthy population. The primary outcome was the composite of estimated glomerular filtration rate decline ≥50% or end-stage renal disease. The secondary outcome included a composite of morbidity and mortality from cardiovascular causes. Animal models were used to simulate fluid retention observed in human CKD. We found that patients with volume overload were at a higher risk of the primary and secondary end points in the adjusted Cox models. Furthermore, overhydration appears to be more important than hypertension in predicting an elevated risk. In rats subjected to unilateral nephrectomy and a high-salt diet, the extracellular water significantly increased. This fluid retention was associated with an increase in blood pressure, proteinuria, renal inflammation with macrophage infiltration and tumor necrosis factor-α overexpression, glomerular sclerosis, and cardiac fibrosis. Diuretic treatment with indapamide attenuated these changes, suggesting that fluid retention might play a role in the development of adverse outcomes.

conclusionsVolume overload contributes to CKD progression and cardiovascular diseases. Further research is warranted to clarify whether the correction of volume overload would improve outcomes for CKD patients.

Indexed as

AgedAged, 80 and overAnimalsBody FluidsCardiovascular DiseasesComorbidityDisease ProgressionFemaleFollow-Up StudiesGlomerular Filtration RateHumansHypertensionKidney Failure, ChronicMaleMiddle AgedProportional Hazards Modelsbioimpedancecardiovascular diseasechronic kidney diseasehypertensionoverhydrationvolume overload

Identifiers

PMID25944876
PMCPMC4599419
OpenAlexW2129524037

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.