Evidence map›Paper›PMID 26867814›Full record

ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2016

Incremental Hemodialysis, Residual Kidney Function, and Mortality Risk in Incident Dialysis Patients: A Cohort Study.

Yoshitsugu Obi, Elani Streja, Connie M Rhee, Vanessa Ravel, Alpesh N Amin, Adamasco Cupisti, Jing Chen, Anna T Mathew, Csaba P Kovesdy, Rajnish Mehrotra and 1 more

3 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 115 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
115citing papers in PubMed, 6 pooled it
26.1field-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.

NCT03239808 naactive not recruitingnot on this mapstarted 2018, after this paper: background citation

Assessment of the Incremental Haemodialysis Security and Effectiveness in Incident Patients

TypeinterventionalSponsorFundación para la Formación e Investigación de los Profesionales de la Salud de ExtremaduraRan2018 to 2025Enrolled152ConditionsRenal Disease, End-StageArmsIncremental haemodialysis, Conventional haemodialysis
NCT03352271 nacompletednot on this mapstarted 2017, after this paper: background citation

Comparison of Clinical Outcomes Between Thrice-weekly and Individualized Incremental Hemodialysis in Incident Hemodialysis Patients

TypeinterventionalSponsorAlexandria UniversityRan2017 to 2020Enrolled122ConditionsHemodialysis Complication, ESRD, Renal FailureArmsIndividualized Incremental hemodialysis, Conventional thrice weekly hemodialysis
NCT06243900 unknown statusnot on this mapstarted 2024, after this paper: background citation

NIRS: a Tool for the Diagnosis of Residual Renal Function Injury in Hemodialysis Patients

TypeobservationalSponsorYuanjun YangRan2024 to 2026Enrolled30ConditionsEnd-stage Renal Disease (ESRD)
3 · Its place in the literature

Who cites it

115 citing papers in PubMed, 6 syntheses or guidelines pooled it, 223 citations in OpenAlex.

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  3. Impact of incremental initiation of haemodialysis on mortality: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023
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55 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 3 countries.

Yoshitsugu ObiHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA.
Elani StrejaHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA.
Connie M RheeHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA.
Vanessa RavelHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA.
Alpesh N AminDepartment of Medicine, University of California Irvine, Orange, CA.
Adamasco CupistiDivision of Nephrology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Jing ChenDivision of Nephrology, Huashan Hospital, Fudan University, Yangpu, Shanghai, China.
Anna T MathewHofstra North Shore-LIJ School of Medicine, Division of Kidney Diseases and Hypertension, North Shore-LIJ Health System, Great Neck, NY.
Csaba P KovesdyDivision of Nephrology, University of Tennessee Health Science Center, Memphis, TN; Nephrology Section, Memphis VA Medical Center, Memphis, TN.
Rajnish MehrotraKidney Research Institute and Harborview Medical Center, Division of Nephrology, University of Washington, Seattle, WA.
Kamyar Kalantar-ZadehHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA; Fielding School of Public Health at UCLA, Los Angeles, CA; Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA. Electronic address: kkz@uci.edu.
University of California, Irvine · USFudan University · CNNorthwell Health · USThe Lundquist Institute · USUniversity of Pisa · ITUniversity of Tennessee Health Science Center · USUniversity of Washington · US

Funding

University of California Health Participation in the National COVID Cohort Collaborative (N3C)UL1TR001414 · NCATS · UNIVERSITY OF CALIFORNIA-IRVINE · PI COOPER, DAN M, VILAIN, ERIC J. · 2015 to 2023
$35.1M
MALNUTRITION, DIET AND RACIAL DISPARITIES IN CKDK24DK091419 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI KALANTAR-ZADEH, KAMYAR · 2011 to 2020
$1.8M
Examining Racial and Cardiovascular Paradoxes in Chronic Kidney DiseaseR01DK078106 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KALANTAR-ZADEH, KAMYAR · 2007 to 2011
$1.1M
Comparative Effectiveness of Dialysis ModalitiesR01DK095668 · NIDDK · UNIVERSITY OF WASHINGTON · PI KALANTAR-ZADEH, KAMYAR, MEHROTRA, RAJNISH · 2012 to 2014
$1.0M
Racial and Cardiovascular Risk Factor Anomalies in CKDR01DK096920 · NIDDK · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · PI KALANTAR-ZADEH, KAMYAR, KOVESDY, CSABA PAL · 2013 to 2015
$909k
NCATS NIH HHS UL1 TR001414NIDDK NIH HHS K24 DK091419NIDDK NIH HHS R01 DK078106NIDDK NIH HHS R01 DK095668NIDDK NIH HHS R01 DK096920
6 · The paper itself

Abstract

backgroundMaintenance hemodialysis is typically prescribed thrice weekly irrespective of a patient's residual kidney function (RKF). We hypothesized that a less frequent schedule at hemodialysis therapy initiation is associated with greater preservation of RKF without compromising survival among patients with substantial RKF. STUDY

designA longitudinal cohort. SETTING &

participants23,645 patients who initiated maintenance hemodialysis therapy in a large dialysis organization in the United States (January 2007 to December 2010), had available RKF data during the first 91 days (or quarter) of dialysis, and survived the first year. PREDICTOR: Incremental (routine twice weekly for >6 continuous weeks during the first 91 days upon transition to dialysis) versus conventional (thrice weekly) hemodialysis regimens during the same time. OUTCOMES: Changes in renal urea clearance and urine volume during 1 year after the first quarter and survival after the first year.

resultsAmong 23,645 included patients, 51% had substantial renal urea clearance (≥3.0mL/min/1.73m(2)) at baseline. Compared with 8,068 patients with conventional hemodialysis regimens matched based on baseline renal urea clearance, urine volume, age, sex, diabetes, and central venous catheter use, 351 patients with incremental regimens exhibited 16% (95% CI, 5%-28%) and 15% (95% CI, 2%-30%) more preserved renal urea clearance and urine volume at the second quarter, respectively, which persisted across the following quarters. Incremental regimens showed higher mortality risk in patients with inadequate baseline renal urea clearance (≤3.0mL/min/1.73m(2); HR, 1.61; 95% CI, 1.07-2.44), but not in those with higher baseline renal urea clearance (HR, 0.99; 95% CI, 0.76-1.28). Results were similar in a subgroup defined by baseline urine volume of 600mL/d. LIMITATIONS: Potential selection bias and wide CIs.

conclusionsAmong incident hemodialysis patients with substantial RKF, incremental hemodialysis may be a safe treatment regimen and is associated with greater preservation of RKF, whereas higher mortality is observed after the first year of dialysis in those with the lowest RKF. Clinical trials are needed to examine the safety and effectiveness of twice-weekly hemodialysis.

Indexed as

AgedCohort StudiesFemaleHumansKidneyKidney Failure, ChronicLongitudinal StudiesMaleMiddle AgedRenal DialysisRiskdialysis initiationfrequent hemodialysisIncremental hemodialysisinterdialytic weight gainmortalityrenal urea clearanceresidual kidney function (RKF)standard Kt/Vtreatment regimentwice-weekly hemodialysis

Identifiers

PMID26867814
PMCPMC4969165
OpenAlexW2260668761

What OpenQuestion holds

Textmetadata
LicenceTDM
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.