Evidence map›Paper›PMID 27804262›Full record

ArticleHemodialysis international. International Symposium on Home Hemodialysis2017

Effects of end-stage renal disease and dialysis modalities on blood ammonia level.

Nosratola D Vaziri, Mahyar Khazaeli, Ane C F Nunes, Kevin T Harley, Hyder Said, Omeed Alipour, Wei Ling Lau, Madeleine V Pahl

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PubMed Full text at PMC Publisher
In one paragraph

Article in Hemodialysis international. International Symposium on Home Hemodialysis, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.4field-weighted citation impact, top 31% 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

6 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Acidosis, cognitive dysfunction and motor impairments in patients with kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021
    Review
  5. Article
  6. The Story of Ammonia in Liver Disease: An Unraveling Continuum.Journal of clinical and experimental hepatology
    Review
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 1 institution in 1 country.

Nosratola D VaziriDivision of Nephrology and Hypertension, University of California, Irvine, Irvine, California, USA.
Mahyar KhazaeliDivision of Nephrology and Hypertension, University of California, Irvine, Irvine, California, USA.
Ane C F NunesDivision of Nephrology and Hypertension, University of California, Irvine, Irvine, California, USA.
Kevin T HarleyDivision of Nephrology and Hypertension, University of California, Irvine, Irvine, California, USA.
Hyder SaidDivision of Nephrology and Hypertension, University of California, Irvine, Irvine, California, USA.
Omeed AlipourDivision of Nephrology and Hypertension, University of California, Irvine, Irvine, California, USA.
Wei Ling LauDivision of Nephrology and Hypertension, University of California, Irvine, Irvine, California, USA.
Madeleine V PahlDivision of Nephrology and Hypertension, University of California, Irvine, Irvine, California, USA.
University of California, Irvine · 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
NCATS NIH HHS UL1 TR001414
6 · The paper itself

Abstract

introductionUremia results in a characteristic breath odor (uremic fetor) which is largely due to its high ammonia content. Earlier studies have shown a strong correlation between breath ammonia and blood urea levels and a 10-fold reduction in breath ammonia after hemodialysis in patients with chronic kidney disease. Potential sources of breath ammonia include: (i) local ammonia production from hydrolysis of urea in the oropharyngeal and respiratory tracts by bacterial flora, and (ii) release of circulating blood ammonia by the lungs. While the effects of uremia and hemodialysis on breath ammonia are well known their effects on blood ammonia are unknown and were explored here.

methodsBlood samples were obtained from 23 hemodialysis patients (immediately before and after dialysis), 14 peritoneal dialysis patients, and 10 healthy controls. Blood levels of ammonia, creatinine, urea, and electrolytes were measured.

findingsNo significant difference was found in baseline blood ammonia between hemodialysis, peritoneal dialysis and control groups. Hemodialysis procedure led to a significant reduction in urea concentration (P < 0.001) which was paradoxically accompanied by a modest but significant (P < 0.05) rise in blood ammonia level in 10 of the 23 patients studied. Change in blood ammonia pre- and post-hemodialysis correlated with change in serum bicarbonate levels (r = 0.61, P < 0.01). On subgroup analysis of patients who had a rise in blood ammonia levels after dialysis, there was a strong correlation with drop in mean arterial pressure (r = 0.88, P < 0.01). The nadir intradialytic systolic blood pressure trended lower in the hemodialysis patients who had a rise in blood ammonia compared to the patients who manifested a fall in blood ammonia (124 ± 8 vs. 136 ± 6 mmHg respectively, P = 0.27). DISCUSSION: Fall in blood urea following hemodialysis in ESRD patients was paradoxically accompanied by a modest rise in blood ammonia levels in 43% of the patients studied, contrasting prior reported effects of hemodialysis on breath ammonia. In this subgroup of patients, changes in blood ammonia during hemodialysis correlated with rise in blood bicarbonate and fall in mean arterial blood pressure.

Indexed as

AmmoniaFemaleHumansKidney Failure, ChronicMaleMiddle AgedRenal DialysisUremiaAmmoniachronic kidney diseasedialysisinflammationureaUremia

Identifiers

PMID27804262
PMCPMC5812671
OpenAlexW2547893058

What OpenQuestion holds

Textmetadata
LicenceTDM
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.