Evidence map›Paper›PMID 26787777›Full record

ArticleClinical journal of the American Society of Nephrology : CJASN2016

Peripheral Edema, Central Venous Pressure, and Risk of AKI in Critical Illness.

Kenneth P Chen, Susan Cavender, Joon Lee, Mengling Feng, Roger G Mark, Leo Anthony Celi, Kenneth J Mukamal, John Danziger

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical journal of the American Society of Nephrology : CJASN, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07722325 (Venous Return Pressure Gradient Predicts Acute Kidney Injury Onset and Progression), which is not on this map. Cited by 74 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 2 pooled it
16.0field-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.

NCT07722325 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Venous Return Pressure Gradient Predicts Acute Kidney Injury Onset and Progression

TypeobservationalSponsorSichuan Academy of Medical SciencesRan2026 to 2027Enrolled180ConditionsAKI - Acute Kidney InjuryArmsNo study intervention
3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 2 syntheses or guidelines pooled it, 157 citations in OpenAlex.

  1. Pooled it
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  6. Rethinking ejection fraction for anesthesiologists: a narrative review.Perioperative medicine (London, England) · 2026
    Review
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14 more citing papers are in PubMed but not listed here.

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

8 authors at 3 institutions in 3 countries.

Kenneth P ChenDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts;
Susan CavenderDivision of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, Massachusetts;
Joon LeeDivision of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, Massachusetts; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; and.
Mengling FengDivision of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, Massachusetts; Data Analytics Department, Institute for Infocomm Research, Agency for Science, Technology And Research, Singapore.
Roger G MarkDivision of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, Massachusetts;
Leo Anthony CeliDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Division of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, Massachusetts;
Kenneth J MukamalDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts;
John DanzigerDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; jdanzige@bidmc.harvard.edu.
Beth Israel Deaconess Medical Center · USMassachusetts Institute of Technology · USHarvard–MIT Division of Health Sciences and Technology · US

Funding

Integrating Data, Models, and Reasoning in Critical CareR01EB001659 · NIBIB · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI MARK, ROGER GREENWOOD · 2003 to 2012
$9.8M
Research Resource for Complex Physiologic SignalsR01GM104987 · NIGMS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI GOLDBERGER, ARY LOUIS, MARK, ROGER GREENWOOD · 2012 to 2019
$5.8M
NIBIB NIH HHS 2R01 EB001659NIBIB NIH HHS R01 EB001659NIGMS NIH HHS R01 GM104987
6 · The paper itself

Abstract

BACKGROUND AND

objectivesAlthough venous congestion has been linked to renal dysfunction in heart failure, its significance in a broader context has not been investigated. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using an inception cohort of 12,778 critically ill adult patients admitted to an urban tertiary medical center between 2001 and 2008, we examined whether the presence of peripheral edema on admission physical examination was associated with an increased risk of AKI within the first 7 days of critical illness. In addition, in those with admission central venous pressure (CVP) measurements, we examined the association of CVPs with subsequent AKI. AKI was defined using the Kidney Disease Improving Global Outcomes criteria.

resultsOf the 18% (n=2338) of patients with peripheral edema on admission, 27% (n=631) developed AKI, compared with 16% (n=1713) of those without peripheral edema. In a model that included adjustment for comorbidities, severity of illness, and the presence of pulmonary edema, peripheral edema was associated with a 30% higher risk of AKI (95% confidence interval [95% CI], 1.15 to 1.46; P<0.001), whereas pulmonary edema was not significantly related to risk. Peripheral edema was also associated with a 13% higher adjusted risk of a higher AKI stage (95% CI, 1.07 to 1.20; P<0.001). Furthermore, levels of trace, 1+, 2+, and 3+ edema were associated with 34% (95% CI, 1.10 to 1.65), 17% (95% CI, 0.96 to 1.14), 47% (95% CI, 1.18 to 1.83), and 57% (95% CI, 1.07 to 2.31) higher adjusted risk of AKI, respectively, compared with edema-free patients. In the 4761 patients with admission CVP measurements, each 1 cm H2O higher CVP was associated with a 2% higher adjusted risk of AKI (95% CI, 1.00 to 1.03; P=0.02).

conclusionsVenous congestion, as manifested as either peripheral edema or increased CVP, is directly associated with AKI in critically ill patients. Whether treatment of venous congestion with diuretics can modify this risk will require further study.

Indexed as

Acute Kidney InjuryAgedCentral Venous PressureCritical IllnessEdemaFemaleHumansMaleMiddle AgedRisk Assessmentacute kidney injuryacute renal failurecentral venous pressurecomorbiditycritical illnessedemaheart failurehumanspulmonary edemarenal function

Identifiers

PMID26787777
PMCPMC4822669
OpenAlexW2277638492

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.