Evidence map›Paper›PMID 28130379›Full record

Trial reportCirculation. Heart failure2017

Impact of Ultrafiltration on Serum Sodium Homeostasis and its Clinical Implication in Patients With Acute Heart Failure, Congestion, and Worsening Renal Function.

Takeshi Kitai, Justin L Grodin, Yong-Hyun Kim, W H Wilson Tang

Erratum issued Registry-linked trialOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation. Heart failure, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT00608491 (CARdiorenal REScue Study in Acute Decompensated Heart Failure), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.2field-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.

NCT00608491 phase3completednot on this map

CARdiorenal REScue Study in Acute Decompensated Heart Failure: CARRESS

TypeinterventionalSponsorDuke UniversityRan2008 to 2012Enrolled188ConditionsHeart FailureArmsStepped pharmacologic care, Ultrafiltration
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Ultrafiltration for acute heart failure.The Cochrane database of systematic reviews · 2022
    Pooled it
  2. Review
  3. Review
  4. Review
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Takeshi KitaiFrom the Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (T.K., Y.-H.K., W.H.W.T.); Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (J.L.G.); and Cardiovascular Division, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Republic of Korea (Y.-H.K.).
Justin L GrodinFrom the Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (T.K., Y.-H.K., W.H.W.T.); Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (J.L.G.); and Cardiovascular Division, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Republic of Korea (Y.-H.K.).
Yong-Hyun KimFrom the Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (T.K., Y.-H.K., W.H.W.T.); Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (J.L.G.); and Cardiovascular Division, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Republic of Korea (Y.-H.K.).
W H Wilson TangFrom the Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (T.K., Y.-H.K., W.H.W.T.); Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (J.L.G.); and Cardiovascular Division, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Republic of Korea (Y.-H.K.). tangw@ccf.org.
The University of Texas Southwestern Medical Center · US

Funding

Nitrative stress in heart failureR01HL103931 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI TANG, WAI HONG WILSON · 2010 to 2014
$3.8M
NHLBI NIH HHS R01 HL103931
6 · The paper itself

Abstract

backgroundThe relationship between changes in serum sodium with clinical events in acute heart failure patients using different decongestive events has not been investigated. This study aimed to describe changes in serum sodium levels during decongestion therapy in patients receiving stepped pharmacological therapy versus ultrafiltration. METHODS AND

resultsWe studied 188 patients who were enrolled in the CARRESS-HF trial (Cardiorenal Rescue Study in Acute Decompensated Heart Failure). Treatment-induced hyponatremia was defined as admission normonatremia (≥135 mEq/L) with a subsequent decrease (<135 mEq/L) during hospitalization. Patients treated with ultrafiltration had significantly lower sodium levels than those with conventional treatment at days 1, 4, and 7 (all P<0.01), whereas those at day 30 were similar between the groups. Changes in sodium levels in patients with ultrafiltration were negatively correlated to those in serum creatinine and plasma renin activity. The incidence of treatment-induced hyponatremia was significantly higher in the ultrafiltration group than those receiving conventional treatment (P=0.002). Although patients with discharge hyponatremia had a higher risk for composite end point of all-cause death, rehospitalization, or unscheduled hospital visit in comparison to those without (adjusted hazard ratio, 2.01; 95% confidence interval, 1.09-3.70; P=0.025), the risk was comparable between patients with treatment-induced hyponatremia and those who did not experience any hyponatremia (adjusted hazard ratio, 0.99; 95% confidence interval, 0.50-1.96; P=0.99).

conclusionsFluid removal by ultrafiltration was associated with a decrease in serum sodium levels compared with diuretic treatment but returned to baseline levels at day 30. Discharge hyponatremia but not treatment-induced hyponatremia was associated with worse clinical outcomes. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00608491.

Indexed as

HemofiltrationAcute DiseaseAgedAged, 80 and overBiomarkersCreatinineDiureticsFemaleHeart FailureHumansHyponatremiaKidneyMaleMiddle AgedProspective StudiesReninBiomarkersCreatinineDiureticsReninSodiumcreatininediureticsheart failurehyponatremiaultrafiltration

Identifiers

PMID28130379
PMCPMC5308796
OpenAlexW2582619141

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.