SynthesisJournal of the American Society of Nephrology : JASN2016
Evaluation of Short-Term Changes in Serum Creatinine Level as a Meaningful End Point in Randomized Clinical Trials.
Synthesis in Journal of the American Society of Nephrology : JASN, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses 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, 2 syntheses or guidelines pooled it.
- Meta-analytic Techniques to Assess the Association Between N-acetylcysteine and Acute Kidney Injury After Contrast Administration: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- Ultrafiltration for acute heart failure.The Cochrane database of systematic reviews · 2022Pooled it
- AKI as a systemic syndrome and its impact on other organ systems.Critical care (London, England) · 2026Review
- Acute Kidney Injury as a Safety End Point in Non-Acute Kidney Injury Clinical Trials.Journal of the American Society of Nephrology : JASN · 2026Article
- The Furosemide Stress Test: A Dynamic Tool for Predicting Acute Kidney Injury Progression in Critical Care Medicine.Journal of clinical medicine · 2025Review
- Association between blood lead levels and serum creatinine: a cross-sectional study.International urology and nephrology · 2025Article
- Improving Processes of Care after Acute Kidney Injury.Journal of the American Society of Nephrology : JASN · 2025Article
- Definitions of Hemodynamic Instability Related to Renal Replacement Therapy in Critically Ill Patients: A Systematic Review Protocol.Canadian journal of kidney health and disease · 2025Article
- Association of Dip in eGFR With Clinical Outcomes in Unilateral Primary Aldosteronism Patients After Adrenalectomy.The Journal of clinical endocrinology and metabolism · 2024Article
- Systemic reserve dysfunction and contrast-associated acute kidney injury following percutaneous coronary intervention.PloS one · 2024Article
- Risk for Chronic Kidney Disease Progression After Acute Kidney Injury: Findings From the Chronic Renal Insufficiency Cohort Study.Annals of internal medicine · 2023Article
- Contrast-Associated Acute Kidney Injury.Journal of clinical medicine · 2022Review
- Impact of contrast-induced acute kidney injury on long-term major adverse cardiovascular events and kidney function after percutaneous coronary intervention: insights from a territory-wide cohort study in Hong Kong.Clinical kidney journal · 2022Article
- The Effects of Resistant Starch Consumption in Adult Patients With Chronic Kidney Disease: A Systematic Review.Canadian journal of kidney health and disease · 2022Article
- Change in Kidney Function and 2-Year Mortality After Transcatheter Aortic Valve Replacement.JAMA network open · 2021Article
- 90 days impacts of remote ischemic preconditioning on patients undergoing open total aortic arch replacement: a post-hoc analysis of previous trial.BMC anesthesiology · 2020Article
- Biomarker of persistent acute kidney injury: another gemstone in the jewelry box.Intensive care medicine · 2020Article
- Long-term outcomes of acute kidney injury and strategies for improved care.Nature reviews. Nephrology · 2020Review
- Save the Brain First: CTA and Mechanical Thrombectomy in Patients at Risk for Contrast-Induced Nephropathy.AJNR. American journal of neuroradiology · 2020Article
- Research-based versus clinical serum creatinine measurements and the association of acute kidney injury with subsequent kidney function: findings from the Chronic Renal Insufficiency Cohort study.Clinical kidney journal · 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
7 authors.
Funding
Abstract
Observational studies have shown that acute change in kidney function (specifically, AKI) is a strong risk factor for poor outcomes. Thus, the outcome of acute change in serum creatinine level, regardless of underlying biology or etiology, is frequently used in clinical trials as both efficacy and safety end points. We performed a meta-analysis of clinical trials to quantify the relationship between positive or negative short-term effects of interventions on change in serum creatinine level and more meaningful clinical outcomes. After a thorough literature search, we included 14 randomized trials of interventions that altered risk for an acute increase in serum creatinine level and had reported between-group differences in CKD and/or mortality rate ≥3 months after randomization. Seven trials assessed interventions that, compared with placebo, increased risk of acute elevation in serum creatinine level (pooled relative risk, 1.52; 95% confidence interval, 1.22 to 1.89), and seven trials assessed interventions that, compared with placebo, reduced risk of acute elevation in serum creatinine level (pooled relative risk, 0.57; 95% confidence interval, 0.44 to 0.74). However, pooled risks for CKD and mortality associated with interventions did not differ from those with placebo in either group. In conclusion, several interventions that affect risk of acute, mild to moderate, often temporary elevation in serum creatinine level in placebo-controlled randomized trials showed no appreciable effect on CKD or mortality months later, raising questions about the value of using small to moderate changes in serum creatinine level as end points in clinical trials.
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Registered trials
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