ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2015
Association of Predialysis Calculated Plasma Osmolarity With Intradialytic Blood Pressure Decline.
Article 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 27 papers, 1 of them a synthesis 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
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Dialysate temperature reduction for intradialytic hypotension for people with chronic kidney disease requiring haemodialysis.The Cochrane database of systematic reviews · 2019Pooled it
- A randomized controlled trial of two dialysate sodium concentrations in hospitalized hemodialysis patients.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022Trial
- Hypertonic Mannitol for the Prevention of Intradialytic Hypotension: A Randomized Controlled Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2019Trial
- A Narrative Summary of Strategies to Mitigate Intradialytic Hypotension in Poisoned Patients Requiring Extracorporeal Toxin Elimination.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Review
- Pressor Response Index During Blood Return as a Marker for Identifying Intradialytic Hypotension.Hemodialysis international. International Symposium on Home Hemodialysis · 2026Article
- Factors Influencing Intraocular Pressure Elevation During Hemodialysis.Translational vision science & technology · 2026Observational
- Cardiovascular implications of osmotic changes during hemodialysis: a potential risk factor.International urology and nephrology · 2026Article
- Intradialytic cerebral blood flow reduction occurs irrespective of vascular access type: a comparative study.BMC nephrology · 2026Article
- Intradialytic hypotension and worse outcomes in patients with acute kidney injury requiring intermittent hemodialysis.Kidney research and clinical practice · 2026Article
- Prevalence and associated factors of intradialytic hypotension among patients with kidney failure on maintenance hemodialysis at Kiruddu National Referral Hospital, Uganda.BMC nephrology · 2025Article
- Renal perfusion pressure: role and implications in critical illness.Annals of intensive care · 2025Review
- Article
- Focus on oliguria during renal replacement therapy.Journal of anesthesia · 2024Review
- An update review on hemodynamic instability in renal replacement therapy patients.International urology and nephrology · 2023Review
- Prevention of Intradialytic Hypotension in Hemodialysis Patients: Current Challenges and Future Prospects.International journal of nephrology and renovascular disease · 2023Review
- Analysis of the Relationships between Mean Red Blood Cell Volume, Red Blood Cell Distribution Width and Hypotension in Patients with Hemodialysis.Iranian journal of public health · 2021Article
- Seasonal variation and predictors of intradialytic blood pressure decline: a retrospective cohort study.Hypertension research : official journal of the Japanese Society of Hypertension · 2021Article
- Serum sodium variation is a major determinant of peridialytic blood pressure trends in haemodialysis outpatients.Scientific reports · 2021Article
- Management of acute intradialytic cardiovascular complications: Updated overview (Review).Experimental and therapeutic medicine · 2021Review
- Cerebral blood flow regulation in end-stage kidney disease.American journal of physiology. Renal physiology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe rapid reduction in plasma osmolality during hemodialysis (HD) may induce temporary gradients that promote the movement of water from the extracellular to the intracellular compartment, predisposing to the development of intradialytic hypotension (IDH). STUDY
designObservational cohort study. SETTING &
participants3,142 prevalent patients receiving thrice-weekly HD from a single dialysis provider organization. PREDICTOR: Predialysis calculated plasma osmolarity (calculated after the 2-day interval as 2 × serum sodium + serum urea nitrogen/2.8 + serum glucose/18). OUTCOME: Magnitude of systolic blood pressure (SBP) decline (predialysis SBP - nadir intradialytic SBP) and risk of IDH (SBP decline > 35 or nadir SBP < 90 mm Hg). MEASUREMENTS: Unadjusted and multivariable-adjusted generalized linear models were fit to estimate the association of calculated osmolarity with intradialytic SBP decline and the odds of developing IDH.
resultsMean age of participants was 62.6±15.2 (SD) years, 57.1% were men, and 61.0% had diabetes. Mean predialysis calculated osmolarity during follow-up was 306.4 ± 9.5 mOsm/L. After case-mix adjustment, each 10-mOsm/L increase in predialysis calculated osmolarity was associated with 1.48 (95% CI, 0.86-2.09) mm Hg (P < 0.001) greater decline in intradialytic SBP and 10% greater odds of IDH (OR, 1.10; 95% CI, 1.05-1.15). In adjusted models, lower predialysis sodium and higher serum urea nitrogen and serum glucose levels were associated with greater decline in intradialytic SBP. LIMITATIONS: Measured serum osmolality, timing of changes in intradialytic osmolality, dialysate osmolality, and dialysate temperature were not available.
conclusionsHigher predialysis calculated osmolarity is associated with greater decline in intradialytic SBP and greater risk of IDH in maintenance HD patients. Strategies to minimize rapid shifts in osmolality should be tested prospectively to minimize excess SBP decline in susceptible patients.
Indexed as
Identifiers
What OpenQuestion holds
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.