Evidence map›Paper›PMID 28270412›Full record

ArticleJournal of the American Society of Nephrology : JASN2017

Relationship between Hypotension and Cerebral Ischemia during Hemodialysis.

Clare MacEwen, Sheera Sutherland, Jonathan Daly, Christopher Pugh, Lionel Tarassenko

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Society of Nephrology : JASN, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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

97 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Cognitive Impairment in End Stage Renal Disease Patients Undergoing Hemodialysis: Markers and Risk Factors.International journal of environmental research and public health · 2022
    Pooled it
  3. Pooled it
  4. Guideline
  5. Pooled it
  6. Trial
  7. Trial
  8. Kidney Disease, Hypertension Treatment, and Cerebral Perfusion and Structure.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022
    Trial
  9. Treating Home Versus Predialysis Blood Pressure Among In-Center Hemodialysis Patients: A Pilot Randomized Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2021
    Trial
  10. Trial
  11. Changes in cerebral oxygenation and cerebral blood flow during hemodialysis - A simultaneous near-infrared spectroscopy and positron emission tomography study.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020
    Trial
  12. Hypertonic Mannitol for the Prevention of Intradialytic Hypotension: A Randomized Controlled Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2019
    Trial
  13. Review
  14. Article
  15. Review
  16. Review
  17. Article
  18. Observational
  19. Observational
  20. Article

37 more citing papers are in PubMed but not listed here.

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.

Clare MacEwenOxford Kidney Unit, Oxford University Hospitals National Health Service Trust, Oxford, United Kingdom; clare.macewen@ouh.nhs.uk.
Sheera SutherlandOxford Kidney Unit, Oxford University Hospitals National Health Service Trust, Oxford, United Kingdom.
Jonathan DalyInstitute of Biomedical Engineering, Department of Engineering Science, and.
Christopher PughOxford Kidney Unit, Oxford University Hospitals National Health Service Trust, Oxford, United Kingdom.
Lionel TarassenkoInstitute of Biomedical Engineering, Department of Engineering Science, and.

Funding

Department of Health DRF-2012-05-710
6 · The paper itself

Abstract

The relationship between BP and downstream ischemia during hemodialysis has not been characterized. We studied the dynamic relationship between BP, real-time symptoms, and cerebral oxygenation during hemodialysis, using continuous BP and cerebral oxygenation measurements prospectively gathered from 635 real-world hemodialysis sessions in 58 prevalent patients. We examined the relationship between BP and cerebral ischemia (relative drop in cerebral saturation >15%) and explored the lower limit of cerebral autoregulation at patient and population levels. Furthermore, we estimated intradialytic exposure to cerebral ischemia and hypotension for each patient, and entered these values into multivariate models predicting change in cognitive function. In all, 23.5% of hemodialysis sessions featured cerebral ischemia; 31.9% of these events were symptomatic. Episodes of hypotension were common, with mean arterial pressure falling by a median of 22 mmHg (interquartile range, 14.3-31.9 mmHg) and dropping below 60 mmHg in 24% of sessions. Every 10 mmHg drop from baseline in mean arterial pressure associated with a 3% increase in ischemic events (

Indexed as

Renal DialysisAgedBrain IschemiaFemaleHumansHypotensionMaleMiddle AgedPilot ProjectsProspective Studiescardiovascular physiologycognitive declinehemodialysisintra-dialytic hypotensionischemia

Identifiers

PMID28270412
PMCPMC5533227

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.