Evidence map›Paper›PMID 26584810›Full record

SynthesisJournal of nephrology2016

Stage 5-CKD under nephrology care: to dialyze or not to dialyze, that is the question.

Mario Pacilio, Roberto Minutolo, Carlo Garofalo, Maria Elena Liberti, Giuseppe Conte, Luca De Nicola

Abstract readCase ReportsSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of nephrology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 4 pooled it
1.0field-weighted citation impact, top 24% 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

11 citing papers in PubMed, 4 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Observational
  6. Review
  7. Review
  8. Article
  9. Review
  10. Article
  11. Discussing Conservative Management With Older Patients With CKD: An Interview Study of Nephrologists.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2018
    Article
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

6 authors at 1 institution in 1 country.

Mario PacilioNephrology Division, Second University of Naples-Med School, S.M.d.P Incurabili Hospital, Via Maria Longo 50, 80138, Naples, Italy.
Roberto MinutoloNephrology Division, Second University of Naples-Med School, S.M.d.P Incurabili Hospital, Via Maria Longo 50, 80138, Naples, Italy.
Carlo GarofaloNephrology Division, Second University of Naples-Med School, S.M.d.P Incurabili Hospital, Via Maria Longo 50, 80138, Naples, Italy.
Maria Elena LibertiNephrology Division, Second University of Naples-Med School, S.M.d.P Incurabili Hospital, Via Maria Longo 50, 80138, Naples, Italy.
Giuseppe ConteNephrology Division, Second University of Naples-Med School, S.M.d.P Incurabili Hospital, Via Maria Longo 50, 80138, Naples, Italy.
Luca De NicolaNephrology Division, Second University of Naples-Med School, S.M.d.P Incurabili Hospital, Via Maria Longo 50, 80138, Naples, Italy. luca.denicola@unina2.it.
University of Campania "Luigi Vanvitelli" · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Appropriate timing of starting chronic dialysis in patients with advanced chronic kidney disease (CKD) under nephrology care still is undefined. We systematically reviewed the most recent studies that have compared outcomes of stage 5-CKD under conservative versus substitutive treatment. Eleven studies, most in elderly patients, were identified. Results indicate no advantage of dialysis over conservative management in terms of survival, hospitalization or quality of life. This information is integrated with a case report on a middle-aged CKD patient followed in our clinic who has remained for 15 years in stage 5 despite severe disease. The patient is a diabetic woman who underwent right nephrectomy in 1994 because of renal tuberculosis. In 1999, she commenced regular nephrology care in our clinic and, since 2000, when she was 53 years old, her estimated glomerular filtration rate (eGFR) has been ≤15 ml/min/1.73 m(2). Over the last decade, despite, several episodes of acute kidney injury and placement of permanent percutaneous nephrostomy in 2001, renal function has remained remarkably stable, though severely impaired (eGFR 7.7-5.6 ml/min/1.73 m(2)). Our systematic analysis of the literature and this case report highlight the need for further studies, not limited exclusively to elderly patients, to verify the efficacy of non-dialysis treatment in stage 5-CKD patients. Meanwhile, nephrologists may consider that their intervention can safely prolong for several years the dialysis-free condition in ESRD independently of age.

Indexed as

Renal DialysisAgedFemaleGlomerular Filtration RateHumansKidneyKidney Failure, ChronicPatient SelectionRenal Insufficiency, ChronicRisk FactorsSeverity of Illness IndexTreatment OutcomeCase reportCKDDiabetic kidney diseaseNephrology careProteinuriaSystematic review

Identifiers

PMID26584810
OpenAlexW2226938089

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.