Evidence map›Paper›PMID 25975964›Full record

SynthesisAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2015

A Meta-analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus, and Hypertension With Acute Kidney Injury.

Matthew T James, Morgan E Grams, Mark Woodward, C Raina Elley, Jamie A Green, David C Wheeler, Paul de Jong, Ron T Gansevoort, Andrew S Levey, David G Warnock and 2 more

Open access · greenAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 169 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
169citing papers in PubMed, 8 pooled it
12.7field-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.

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

169 citing papers in PubMed, 8 syntheses or guidelines pooled it, 307 citations in OpenAlex.

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 11 institutions in 6 countries.

Matthew T JamesDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Morgan E GramsJohns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Mark WoodwardJohns Hopkins Bloomberg School of Public Health, Baltimore, MD; The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia; The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
C Raina ElleyDepartment of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland, New Zealand.
Jamie A GreenNephrology Department, Geisinger Medical Center, Danville, PA.
David C WheelerUniversity College London, London, United Kingdom.
Paul de JongUniversity Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Ron T GansevoortUniversity Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Andrew S LeveyDivision of Nephrology at Tufts Medical Center, Boston, MA.
David G WarnockUniversity of Alabama at Birmingham, Birmingham, AL.
Mark J SarnakDivision of Nephrology at Tufts Medical Center, Boston, MA.
CKD Prognosis Consortium
Tufts Medical Center · USJohns Hopkins University · USUniversity Medical Center Groningen · NLUniversity of Alabama at Birmingham · USGeisinger Medical Center · USThe George Institute for Global Health · AUUniversity College London · GBUniversity of Calgary · CAUniversity of Groningen · NLUniversity of Auckland · NZUniversity of Oxford · GB

Funding

Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
University of Alabama at Birmingham's Diabetes Research CenterP30DK079626 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI W Timothy GARVEY · 2013 to 2026
$19.5M
Chronic Kidney Disease Prognosis Consortium (CKD-PC)R01DK100446 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, Morgan Erika Grams · 2014 to 2026
$10.7M
Exceptional Survival: Trajectories to Functional Aging (CHS All Stars)R01AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2004 to 2016
$9.5M
CHS Events Follow-up StudyR01HL080295 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE M · 2009 to 2014
$6.3M
The comparative effectiveness of kidney transplantation in advanced CKDK08DK092287 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI GRAMS, MORGAN ERIKA · 2012 to 2016
$793k
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085083 · HC · UNIVERSITY OF CALIFORNIA DAVIS · PI ROBBINS, JOHN A · 1988 to 1999
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CENTRAL BLOOD ANALYSIS LABORATORY FOR CHSN01HC085086 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1988 to 2000
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CORONARY HEART DISEASE AND STROKE IN PEOPLE AGED 65-84N01HC085082 · HC · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KULLER, LEWIS H · 1988 to 2000
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CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085081 · HC · JOHNS HOPKINS UNIVERSITY · PI FRIED, LINDA P · 1988 to 2000
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CORONARY HEART DISEASE &STROKE IN THE ELDERLYN01HC085080 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1988 to 2000
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CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65 TO 84N01HC085079 · HC · UNIVERSITY OF WASHINGTON · 1988 to 2005
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NCATS NIH HHS UL1 TR001079NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201100005CNHLBI NIH HHS HHSN268201100006CNHLBI NIH HHS HHSN268201100007CNHLBI NIH HHS HHSN268201100008CNHLBI NIH HHS HHSN268201100009CNHLBI NIH HHS HHSN268201100010CNHLBI NIH HHS HHSN268201100011CNHLBI NIH HHS HHSN268201100012CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS R01 HL080295NIA NIH HHS R01 AG023629NIDDK NIH HHS K08 DK092287NIDDK NIH HHS P30 DK079626NIDDK NIH HHS R01 DK100446NIDDK NIH HHS R01DK100446-01
6 · The paper itself

Abstract

backgroundDiabetes mellitus and hypertension are risk factors for acute kidney injury (AKI). Whether estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (ACR) remain risk factors for AKI in the presence and absence of these conditions is uncertain. STUDY

designMeta-analysis of cohort studies. SETTING & POPULATION: 8 general-population (1,285,045 participants) and 5 chronic kidney disease (CKD; 79,519 participants) cohorts. SELECTION CRITERIA FOR STUDIES: Cohorts participating in the CKD Prognosis Consortium. PREDICTORS: Diabetes and hypertension status, eGFR by the 2009 CKD Epidemiology Collaboration creatinine equation, urine ACR, and interactions. OUTCOME: Hospitalization with AKI, using Cox proportional hazards models to estimate HRs of AKI and random-effects meta-analysis to pool results.

resultsDuring a mean follow-up of 4 years, there were 16,480 episodes of AKI in the general-population and 2,087 episodes in the CKD cohorts. Low eGFRs and high ACRs were associated with higher risks of AKI in individuals with or without diabetes and with or without hypertension. When compared to a common reference of eGFR of 80mL/min/1.73m(2) in nondiabetic patients, HRs for AKI were generally higher in diabetic patients at any level of eGFR. The same was true for diabetic patients at all levels of ACR compared with nondiabetic patients. The risk gradient for AKI with lower eGFRs was greater in those without diabetes than with diabetes, but similar with higher ACRs in those without versus with diabetes. Those with hypertension had a higher risk of AKI at eGFRs>60mL/min/1.73m(2) than those without hypertension. However, risk gradients for AKI with both lower eGFRs and higher ACRs were greater for those without than with hypertension. LIMITATIONS: AKI identified by diagnostic code.

conclusionsLower eGFRs and higher ACRs are associated with higher risks of AKI among individuals with or without either diabetes or hypertension.

Indexed as

Acute Kidney InjuryAdultAgedComorbidityDiabetes MellitusDisease ProgressionFemaleGlomerular Filtration RateHumansHypertensionIncidenceKidney Failure, ChronicMaleMiddle AgedPrognosisRenal Insufficiency, Chronicacute kidney injury (AKI)acute renal failure (ARF)albumin-creatine ratio (ACR)albuminuriaChronic Kidney Disease Prognosis ConsortiumdiabetesEstimated glomerular filtration rate (eGFR)hypertensionmeta-analysisrenal function

Identifiers

PMID25975964
PMCPMC4594211
OpenAlexW2155749392

What OpenQuestion holds

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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.