Evidence map›Paper›PMID 27127638›Full record

ArticleOpen heart

Subclinical cardiopulmonary dysfunction in stage 3 chronic kidney disease.

Alexander Nelson, James Otto, John Whittle, Robert C M Stephens, Daniel S Martin, John R Prowle, Gareth L Ackland

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

Article in Open heart. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03064555 (Acute Physiological Response to Exercise in End Stage Renal Disease), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 16% 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.

NCT03064555 completednot on this map

Acute Physiological Response to Exercise in End Stage Renal Disease

Typeobservational_patient_registrySponsorCoventry UniversityRan2017 to 2019Enrolled40ConditionsRenal Disease
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
  6. Article
  7. 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

7 authors at 5 institutions in 1 country.

Alexander NelsonUCL Medical School , London , UK.
James OttoRoyal Free London NHS Foundation Trust , London , UK.
John WhittleDivision of Medicine, Department of Clinical Physiology , University College London , London , UK.
Robert C M StephensDepartment of Anaesthesia , University College London Hospitals NHS Trust , London , UK.
Daniel S MartinRoyal Free London NHS Foundation Trust , London , UK.
John R ProwleWilliam Harvey Research Institute, Queen Mary University of London , London , UK.
Gareth L AcklandWilliam Harvey Research Institute, Queen Mary University of London , London , UK.ORCID 0000-0003-0565-5164
Queen Mary University of London · GBRoyal Free London NHS Foundation Trust · GBUniversity College Hospital · GBUniversity College London · GBUniversity College London Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveReduced exercise capacity is well documented in end-stage chronic kidney disease (CKD), preceded by changes in cardiac morphology in CKD stage 3. However, it is unknown whether subclinical cardiopulmonary dysfunction occurs in CKD stage 3 independently of heart failure.

methodsProspective observational cross-sectional study of exercise capacity assessed by cardiopulmonary exercise testing in 993 preoperative patients. Primary outcome was peak oxygen consumption (VO2peak). Anaerobic threshold (AT), oxygen pulse and exercise-evoked measures of autonomic function were analysed, controlling for CKD stage 3, age, gender, diabetes mellitus and hypertension.

resultsCKD stage 3 was present in 93/993 (9.97%) patients. Diabetes mellitus (RR 2.49 (95% CI 1.59 to 3.89); p<0.001), and hypertension (RR 3.20 (95% CI 2.04 to 5.03); p<0.001)) were more common in CKD stage 3. Cardiac failure (RR 0.83 (95% CI 0.30 to 2.24); p=0.70) and ischaemic heart disease (RR 1.40 (95% CI 0.97 to 2.02); p=0.09) were not more common in CKD stage 3. Patients with CKD stage 3 had lower predicted VO2peak (mean difference: 6% (95% CI 1% to 11%); p=0.02), lower peak heart rate (mean difference:9 bpm (95% CI 3 to 14); p=0.03)), lower AT (mean difference: 1.1 mL/min/kg (95% CI 0.4 to 1.7); p<0.001) and impaired heart rate recovery (mean difference: 4 bpm (95% CI 1 to 7); p<0.001)).

conclusionsSubclinical cardiopulmonary dysfunction in CKD stage 3 is common. This study suggests that maladaptive cardiovascular/autonomic dysfunction may be established in CKD stage 3, preceding pathophysiology reported in end-stage CKD.

Indexed as

AUTONOMIC NERVOUS SYSTEMCARDIAC FUNCTIONRENAL DISEASE

Identifiers

PMID27127638
PMCPMC4847133
OpenAlexW2299013409

What OpenQuestion holds

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LicenceCC BY-NC
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.