Evidence map›Paper›PMID 27871075›Full record

ArticleKidney & blood pressure research2016

Comparative Effectiveness of Renin-Angiotensin System Antagonists in Maintenance Dialysis Patients.

Theresa I Shireman, Jonathan D Mahnken, Milind A Phadnis, Edward F Ellerbeck, James B Wetmore

Open access · goldAbstract readComparative Study
In one paragraph

Article in Kidney & blood pressure research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 24% 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

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

  1. Pooled it
  2. Article
  3. Observational
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

5 authors at 4 institutions in 2 countries.

Theresa I ShiremanCenter for Gerontology & Health Care Research, Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA.
Jonathan D Mahnken
Milind A Phadnis
Edward F Ellerbeck
James B Wetmore
Cancer Research And Biostatistics · USBrown University · USGeneral Department of Preventive Medicine · VNHennepin County Medical Center · US

Funding

Are Cardioprotective Medications Effective in ESRD?R01DK080111 · NIDDK · UNIVERSITY OF KANSAS MEDICAL CENTER · PI SHIREMAN, THERESA I. · 2008 to 2011
$1.4M
Factors Associated with Warfarin Use in Dialysis Patients w/ Atrial FibrillationK23DK085378 · NIDDK · UNIVERSITY OF KANSAS MEDICAL CENTER · PI WETMORE, JAMES BACON · 2010 to 2014
$861k
NIDDK NIH HHS K23 DK085378NIDDK NIH HHS R01 DK080111
6 · The paper itself

Abstract

BACKGROUND/

aimsWhether angiotensin converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARB) are differentially associated with reductions in cardiovascular events and mortality in patients receiving maintenance dialysis is uncertain. We compared outcomes between ACE and ARB users among hypertensive, maintenance dialysis patients.

methodsNational retrospective cohort study of hypertensive, Medicare-Medicaid eligible patients initiating chronic dialysis between 1/1/2000 to 12/31/2005. The exposure of interest was new use of either an ACEI or ARB. Outcomes were all-cause mortality (ACM) and combined cardiovascular hospitalization or death (CV-endpoint). Cox proportion hazards models were used to compare the effect of ACEI vs ARB use on ACM and, separately, CV-endpoint.

resultsACM models were based on 3,555 ACEI and 1,442 ARB new users, while CV-endpoint models included 3,289 ACEI and 1,346 ARB new users. After statistical adjustments, ACEI users had higher hazard ratios for ACM (AHR = 1.22, 99% CI 1.05-1.42) and CV-endpoint (AHR = 1.12, 99% CI 0.99-1.27).

conclusionsPatients initiating maintenance dialysis who received an ACEI faced an increased risk for mortality and a trend towards an increased risk for CV-endpoints when compared to patients who received an ARB. Validation of these results in a rigorous clinical trial is warranted.

Indexed as

AdultAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsCardiovascular DiseasesFemaleHumansHypertensionKidney Failure, ChronicMaleMiddle AgedRenal DialysisRenin-Angiotensin SystemRetrospective StudiesTreatment OutcomeAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor Antagonists

Identifiers

PMID27871075
PMCPMC5445383
OpenAlexW2552857922

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.