Evidence map›Paper›PMID 28089476›Full record

Trial reportAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2017

Serum Asymmetric and Symmetric Dimethylarginine and Morbidity and Mortality in Hemodialysis Patients.

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

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
2.4field-weighted citation impact, top 12% 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

28 citing papers in PubMed, 41 citations in OpenAlex.

  1. Review
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  6. Metabolites Associated With Uremic Symptoms in Patients With CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024
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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

9 authors at 6 institutions in 1 country.

Tariq ShafiDepartment of Medicine, Johns Hopkins University, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD. Electronic address: tshafi@jhmi.edu.
Thomas H HostetterDepartment of Medicine, Case Western University School of Medicine, Cleveland, OH.
Timothy W MeyerDepartment of Medicine, Palo Alto Veterans Affairs Health Care System and Stanford University, Palo Alto, CA.
Seungyoung HwangDepartment of Medicine, Johns Hopkins University, Baltimore, MD.
Xin HaiDepartment of Medicine, Case Western University School of Medicine, Cleveland, OH.
Michal L MelamedDepartment of Medicine, Albert Einstein College of Medicine, Bronx, NY; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
Tanushree BanerjeeDepartment of Medicine, University of California, San Francisco, CA.
Josef CoreshDepartment of Medicine, Johns Hopkins University, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Neil R PoweDepartment of Medicine, University of California, San Francisco, CA.
Johns Hopkins University · USUniversity of California, San Francisco · USAlbert Einstein College of Medicine · USCase Western Reserve University · USVA Palo Alto Health Care System · USWestern University of Health Sciences · US

Funding

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
PATIENT ORIENTED RESEARCH IN KIDNEY DISEASEK24DK002643 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI POWE, NEIL R. · 1999 to 2009
$1.4M
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 HS008365NHLBI NIH HHS R01 HL062985NIDDK NIH HHS K23 DK083514NIDDK NIH HHS K24 DK002643NIDDK NIH HHS R01 DK059616NIDDK NIH HHS R01 DK080123NIDDK NIH HHS R03 DK104012
6 · The paper itself

Abstract

backgroundAsymmetric (ADMA) and symmetric dimethylarginine (SDMA) are putative uremic toxins that may exert toxicity by a number of mechanisms, including impaired nitric oxide synthesis and generation of reactive oxygen species. The study goal was to determine the association between these metabolites and cardiovascular outcomes in hemodialysis patients. STUDY

designPost hoc analysis of the Hemodialysis (HEMO) Study. SETTING &

participants1,276 prevalent hemodialysis patients with available samples 3 to 6 months after randomization. PREDICTOR: ADMA and SDMA measured in stored specimens. OUTCOMES: Cardiac death, sudden cardiac death, first cardiovascular event, and any-cause death. Association with predictors analyzed using Cox regression adjusted for potential confounders (including demographics, clinical characteristics, comorbid conditions, albumin level, and residual kidney function).

resultsMean age of patients was 57±14 (SD) years, 63% were black, and 57% were women. Mean ADMA (0.9±0.2μmol/L) and SDMA levels (4.3±1.4μmol/L) were moderately correlated (r=0.418). Higher dialysis dose or longer session length were not associated with lower predialysis ADMA or SDMA concentrations. In fully adjusted models, each doubling of ADMA level was associated with higher risk (HR per 2-fold higher concentration; 95% CI) of cardiac death (1.83; 1.29-2.58), sudden cardiac death (1.79; 1.19-2.69), first cardiovascular event (1.50; 1.20-1.87), and any-cause death (1.44; 1.13-1.83). Compared to the lowest ADMA quintile (<0.745 μmol/L), the highest ADMA quintile (≥1.07μmol/L) was associated with higher risk (HR; 95% CI) of cardiac death (2.10; 1.44-3.05), sudden cardiac death (2.06; 1.46-2.90), first cardiovascular event (1.75; 1.35-2.27), and any-cause death (1.56; 1.21-2.00). SDMA level was associated with higher risk for cardiac death (HR, 1.40; 95% CI, 1.03-1.92), but this was no longer statistically significant after adjusting for ADMA level (HR, 1.20; 95% CI, 0.86-1.68). LIMITATIONS: Single time-point measurement of ADMA and SDMA.

conclusionsADMA and, to a lesser extent, SDMA levels are associated with cardiovascular outcomes in hemodialysis patients.

Indexed as

Renal DialysisArginineCardiovascular DiseasesFemaleHumansMaleMiddle AgedMorbidityProspective StudiesArginineN,N-dimethylargininesymmetric dimethylarginineasymmetric dimethylarginine (ADMA)cardiac deathcardiovascular morbidityCardiovascular mortalitydialysis outcomesend-stage renal disease (ESRD)hemodialysissudden cardiac deathsymmetric dimethylarginine (SDMA)uremic toxins

Identifiers

PMID28089476
PMCPMC5483385
OpenAlexW2576961624

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.