Evidence map›Paper›PMID 28091865›Full record

ArticleInternational urology and nephrology2017

Improving the diagnostic workup of hyponatremia in the setting of kidney disease: a continuing medical education (CME) initiative.

Ladan Golestaneh, Joel Neugarten, William Southern, Faraj Kargoli, Amanda Raff

Abstract read
PubMed Publisher
In one paragraph

Article in International urology and nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 98% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Association of pre-ESKD hyponatremia with post-ESKD outcomes among incident ESKD patients.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022
    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

5 authors at 2 institutions in 1 country.

Ladan GolestanehMontefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, Bronx, NY, 10467, USA. lgolesta@montefiore.org.
Joel NeugartenMontefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, Bronx, NY, 10467, USA.
William SouthernMontefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, Bronx, NY, 10467, USA.
Faraj KargoliMontefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, Bronx, NY, 10467, USA.
Amanda RaffMontefiore Medical Center, Albert Einstein College of Medicine, 3450 Wayne AveSuite 5H, Bronx, NY, 10467, USA.
Albert Einstein College of Medicine · USMontefiore Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHyponatremia is a common electrolyte disorder and is associated with mortality. We examined the frequency of appropriate testing in response to an episode of inpatient hyponatremia in a large urban hospital to better inform our educational intervention. We then evaluated the impact of a live CME activity with a focus on CKD- and ESRD-associated hyponatremia physiology, on diagnostic practices of audience hospitalist attendings.

methodsWe performed a retrospective database analysis of all patients admitted to Montefiore Medical Center in 2014 to examine the performance of hospital staff in response to hyponatremia across all CKD stages. We then did a comparative analysis of diagnostic workup orders for hyponatremic patients admitted to audience members of a live CME activity in the 4 months prior as compared to the 4 months after the activity.

resultsThe prevalence of hyponatremia was 27% in a cohort of hospitalized patients: 41% of these hyponatremia inpatients had CKD, and 11.4% had ESRD. Overall less than 10% of patients had orders written for serum and urine osmolality without a differential pattern based on CKD or ESRD diagnosis. Among the patients admitted to the CME audience hospitalists, urine/serum osmolality and urine sodium orders occurred infrequently overall and did not differ after vs. before the lecture. DISCUSSION: The frequency of appropriate diagnostic orders written in response to an episode of hyponatremia was very low and did not vary based on degree of CKD. A CME activity with an emphasis on the role of CKD/ESRD in diagnostic accuracy did not improve the order quality in a group of audience hospitalists. Efforts to improve the diagnostic workup of hyponatremia with concomitant kidney disease are crucial to proper management of these patients.

Indexed as

Education, Medical, ContinuingPractice Patterns, Physicians'AdultAgedAged, 80 and overFemaleGlomerular Filtration RateGuideline AdherenceHospitalistsHumansHyponatremiaInterrupted Time Series AnalysisKidney Failure, ChronicMaleMiddle AgedOsmolar ConcentrationSodiumChronic kidney diseaseHyponatremiaMedical education

Identifiers

PMID28091865
OpenAlexW2574873056

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.