Evidence map›Paper›PMID 27059513›Full record

ArticleJournal of the American Society of Nephrology : JASN2016

Relationship between eGFR Decline and Hard Outcomes after Kidney Transplants.

Philip A Clayton, Wai H Lim, Germaine Wong, Steven J Chadban

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article 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 60 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

60 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Mapping health-related quality of life after kidney transplantation by group comparisons: a systematic review.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021
    Pooled it
  2. Trial
  3. A Randomized Trial of Bortezomib in Late Antibody-Mediated Kidney Transplant Rejection.Journal of the American Society of Nephrology : JASN · 2018
    Trial
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Late Allograft Loss and Contemporary Cardiorenal Metabolic Therapies.Journal of the American Society of Nephrology : JASN · 2025
    Review
  13. Article
  14. Review
  15. One-Year HbA1c Predicts Long-Term Pancreas Graft Survival Following SPK Transplantation: A US Population Cohort Study.Transplant international : official journal of the European Society for Organ Transplantation · 2025
    Article
  16. Article
  17. Article
  18. Article
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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

4 authors.

Philip A ClaytonAustralia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia.
Wai H LimAustralia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia.
Germaine WongAustralia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia.
Steven J ChadbanAustralia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia; steve.chadban@sswahs.nsw.gov.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Trials designed to assess the effect of interventions on death and graft failure in kidney transplant recipients are not feasible, because these are predominantly late events. Here, we examined the potential of percentage decline in eGFR as a surrogate for hard outcomes. We obtained deidentified data from the Australia and New Zealand Dialysis and Transplant Registry and studied 7949 transplants performed from 1995 to 2009, including 71,845 patient-years of follow-up, 1121 graft losses, and 1192 deaths. We used adjusted Cox proportional hazards models to determine risks of death or death-censored graft failure related to percentage change in eGFR between years 1 and 3 after transplant. Percentage change in eGFR was modeled as a restricted cubic spline. Rate of eGFR decline associated with exponentially increased risks of graft failure and death. Compared with stable eGFR, a ≥30% decline in eGFR, detected in 10% of patients, strongly associated with subsequent death (hazard ratio, 2.20; 95% confidence interval, 1.87 to 2.60) and death-censored graft failure (hazard ratio, 5.14; 95% confidence interval, 4.44 to 5.95). Decline in eGFR was superior to other surrogates, including acute rejection, doubling of serum creatinine level, and eGFR at year 1 or year 2. We conclude that 30% decline in eGFR between years 1 and 3 after kidney transplant is common and strongly associated with risks of subsequent death and death-censored graft failure, which mirrors findings in CKD. Percentage decline in eGFR should be considered for use as a surrogate outcome in kidney transplant trials.

Indexed as

Glomerular Filtration RateKidney TransplantationFemaleHumansKidneyKidney DiseasesMaleMiddle AgedPostoperative ComplicationsTreatment Outcomeglomerular filtration ratemortalityrenal transplantationtransplant outcomes

Identifiers

PMID27059513
PMCPMC5084878

What OpenQuestion holds

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Registered trials

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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.