Evidence map›Paper›PMID 25979975›Full record

Trial reportClinical journal of the American Society of Nephrology : CJASN2015

Association of BP with Death, Cardiovascular Events, and Progression to Chronic Dialysis in Patients with Advanced Kidney Disease.

Shyamal Palit, Michel Chonchol, Alfred K Cheung, James Kaufman, Gerard Smits, Jessica Kendrick

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 5% 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

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Review
  9. Review
  10. Risks of Adverse Events in Advanced CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2017
    Article
  11. Does a blood pressure J curve exist for patients with chronic kidney disease?Journal of clinical hypertension (Greenwich, Conn.) · 2017
    Review
  12. Observational
  13. Article
  14. Article
  15. BP Components in Advanced CKD and the Competing Risks of Death, ESRD, and Cardiovascular Events.Clinical journal of the American Society of Nephrology : CJASN · 2015
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Shyamal PalitDivision of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, Colorado;
Michel ChoncholDivision of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, Colorado;
Alfred K CheungDivision of Nephrology & Hypertension, University of Utah, Salt Lake City, Utah; Renal Section, Medical Service, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah; and.
James KaufmanResearch Service, Veterans Affairs New York Harbor Healthcare System and Department of Medicine, New York University School of Medicine, New York, New York.
Gerard SmitsDivision of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, Colorado;
Jessica KendrickDivision of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, Colorado; Jessica.Kendrick@ucdenver.edu.
University of Colorado Denver · USNew York University · US

Funding

Vitamin D and Clinical Outcomes in Chronic Hemodialysis PatientsR01DK081473 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI CHONCHOL, MICHEL BENJAMIN · 2009 to 2012
$1.4M
Vitamin D and Arterial Function in Patients with Chronic Kidney DiseaseK23DK087859 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI KENDRICK, JESSICA B · 2011 to 2015
$784k
NIDDK NIH HHS 1R01-DK081473-01NIDDK NIH HHS K23 DK087859NIDDK NIH HHS K23-DK087859NIDDK NIH HHS R01 DK081473
6 · The paper itself

Abstract

BACKGROUND AND

objectiveThe optimal BP target to reduce adverse clinical outcomes in patients with CKD is unclear. This study examined the relationship between BP and death, cardiovascular events (CVEs), and kidney disease progression in patients with advanced kidney disease. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The relationship of systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) with death, CVE, and progression to long-term dialysis was examined in 1099 patients with advanced CKD (eGFR≤30 ml/min per 1.7 3m(2); not receiving dialysis) who participated in the Homocysteine in Kidney and ESRD study. That study enrolled participants from 2001 to 2003. Cox proportional hazard models were used to examine the association between BP and adverse outcomes.

resultsThe mean±SD baseline eGFR was 18±7 ml/min per 1.73 m(2). During a median follow-up of 2.9 years, 453 patients died, 215 had a CVE, and 615 initiated long-term dialysis. After adjustment for demographic characteristics and confounders, SBP, DBP, and PP were not associated with a higher risk of death. SBP and DBP were also not associated with CVE. The highest quartile of PP was associated with a substantial higher risk of CVE compared with the lowest quartile (hazard ratio [HR], 1.67; 95% confidence interval [95% CI], 1.10 to 2.52). The highest quartiles of SBP (HR, 1.28; 95% CI, 1.01 to 1.61) and DBP (HR, 1.36; 95% CI, 1.07 to 1.73), but not PP, were associated with a higher risk of progression to long-term dialysis compared with the lowest quartile.

conclusionsIn patients with advanced kidney disease not undergoing dialysis, higher PP was strongly associated with CVE whereas higher SBP and DBP were associated with progression to long-term dialysis. These results suggest that SBP and DBP should not be the only factors considered in determining antihypertensive therapy; elevated PP should also be considered.

Indexed as

Blood PressureCardiovascular DiseasesRenal DialysisRenal Insufficiency, ChronicAgedAntihypertensive AgentsDisease ProgressionDouble-Blind MethodFemaleGlomerular Filtration RateHumansKidneyMaleMiddle AgedProportional Hazards ModelsProspective StudiesAntihypertensive Agentsblood pressurecardiovascular diseasechronic kidney disease

Identifiers

PMID25979975
PMCPMC4455214
OpenAlexW2105621177

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.