Evidence map›Paper›PMID 27436853›Full record

Trial reportJournal of the American Society of Nephrology : JASN2017

Trimethylamine N-Oxide and Cardiovascular Events in Hemodialysis Patients.

Tariq Shafi, Neil R Powe, Timothy W Meyer, Seungyoung Hwang, Xin Hai, Michal L Melamed, Tanushree Banerjee, Josef Coresh, Thomas H Hostetter

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Society of Nephrology : JASN, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
100citing papers in PubMed, 8 pooled it
12.4field-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.

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

100 citing papers in PubMed, 8 syntheses or guidelines pooled it, 160 citations in OpenAlex.

  1. Pooled it
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  9. Contribution of 'clinically negligible' residual kidney function to clearance of uremic solutes.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2020
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40 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

9 authors at 6 institutions in 1 country.

Tariq ShafiDepartment of Medicine and tshafi@jhmi.edu.
Neil R PoweDepartment of Medicine, University of California, San Francisco, California.
Timothy W MeyerDepartment of Medicine, Palo Alto Veterans Affairs Health Care System and Stanford University, Palo Alto, California.
Seungyoung HwangDepartment of Medicine and.
Xin HaiDepartment of Medicine, Case Western University School of Medicine, Cleveland, Ohio.
Michal L MelamedDepartments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York; and.
Tanushree BanerjeeDepartment of Medicine, University of California, San Francisco, California.
Josef CoreshDepartment of Medicine and.
Thomas H HostetterDepartment of Medicine, Case Western University School of Medicine, Cleveland, Ohio.
Johns Hopkins University · USUniversity of California, San Francisco · USAlbert Einstein College of Medicine · USStanford University · USUniversity School · USWestern University of Health Sciences · US

Funding

Core-010UL1TR001073 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI KELLER, MARLA J, SHAMOON, HARRY · 2013 to 2017
$21.3M
Retained Organic Solutes and Clinical Outcomes in HemodialysisR01DK080123 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI POWE, NEIL R. · 2008 to 2012
$3.2M
PROCESS, OUTCOME AND QUALITY OF CARE IN ESRDR01DK059616 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI POWE, NEIL R. · 2000 to 2004
$3.1M
RISK FACTORS FOR CV DISEASE IN A DIALYSIS COHORTR01HL062985 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI CORESH, JOSEF · 2000 to 2003
$2.4M
Residual Kidney Function in ESRD: Measurements, Serum Markers and OutcomesK23DK083514 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SHAFI, TARIQ · 2010 to 2014
$904k
Volume Management in Dialysis Patients Guided by Pulse Amplitude RationR03DK104012 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SHAFI, TARIQ · 2015 to 2016
$151k
DIALYSIS CARE: CHOICES, OUTCOMES, COSTS AND TRADEOFFSR01HS008365 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI POWE, NEIL R. · 1994 to 1998
–
AHRQ HHS R01 HS008365NCATS NIH HHS UL1 TR001073NHLBI NIH HHS R01 HL062985NIDDK NIH HHS K23 DK083514NIDDK NIH HHS R01 DK059616NIDDK NIH HHS R01 DK080123NIDDK NIH HHS R03 DK104012
6 · The paper itself

Abstract

Cardiovascular disease causes over 50% of the deaths in dialysis patients, and the risk of death is higher in white than in black patients. The underlying mechanisms for these findings are unknown. We determined the association of the proatherogenic metabolite trimethylamine N-oxide (TMAO) with cardiovascular outcomes in hemodialysis patients and assessed whether this association differs by race. We measured TMAO in stored serum samples obtained 3-6 months after randomization from a total of 1232 white and black patients of the Hemodialysis Study, and analyzed the association of TMAO with cardiovascular outcomes using Cox models adjusted for potential confounders (demographics, clinical characteristics, comorbidities, albumin, and residual kidney function). Mean age of the patients was 58 years; 35% of patients were white. TMAO concentration did not differ between whites and blacks. In whites, 2-fold higher TMAO associated with higher risk (hazard ratio [95% confidence interval]) of cardiac death (1.45 [1.24 to 1.69]), sudden cardiac death [1.70 (1.34 to 2.15)], first cardiovascular event (1.15 [1.01 to 1.32]), and any-cause death (1.22 [1.09 to 1.36]). In blacks, the association was nonlinear and significant only for cardiac death among patients with TMAO concentrations below the median (1.58 [1.03 to 2.44]). Compared with blacks in the same quintile, whites in the highest quintile for TMAO (≥135 μM) had a 4-fold higher risk of cardiac or sudden cardiac death and a 2-fold higher risk of any-cause death. We conclude that TMAO concentration associates with cardiovascular events in hemodialysis patients but the effects differ by race.

Indexed as

Renal DialysisBlack PeopleCardiovascular DiseasesFemaleHumansMaleMethylaminesMiddle AgedProspective StudiesWhite PeopleMethylaminestrimethyloxaminecardiovascular eventsepidemiology and outcomeshemodialysis

Identifiers

PMID27436853
PMCPMC5198291
OpenAlexW2478068820

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.