Evidence map›Paper›PMID 28699033›Full record

Observational studyClinical and experimental nephrology2018

Low white blood cell count is independently associated with chronic kidney disease progression in the elderly: the CKD-ROUTE study.

Yohei Arai, Eiichiro Kanda, Soichiro Iimori, Shotaro Naito, Yumi Noda, Sei Sasaki, Eisei Sohara, Tomokazu Okado, Tatemitsu Rai, Shinichi Uchida

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Clinical and experimental nephrology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.3field-weighted citation impact, top 20% 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

11 citing papers in PubMed, 21 citations in OpenAlex.

  1. Article
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  5. Hemogram-Derived Inflammatory Markers in Cats with Chronic Kidney Disease.Animals : an open access journal from MDPI · 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

10 authors at 3 institutions in 1 country.

Yohei AraiDepartment of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
Eiichiro KandaDepartment of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan. tokyo.kyosai.kanda@gmail.com.
Soichiro IimoriDepartment of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
Shotaro NaitoDepartment of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
Yumi NodaDepartment of Nephrology, Nitobe Memorial Nakano General Hospital, Tokyo, Japan.
Sei SasakiDepartment of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
Eisei SoharaDepartment of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
Tomokazu OkadoDepartment of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
Tatemitsu RaiDepartment of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
Shinichi UchidaDepartment of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
Tokyo Medical and Dental University · JPKure Kyosai Hospital · JPNakano General Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElevated white blood cell (WBC) count is a well-known predictor of chronic kidney disease (CKD) progression. However, elderly patients commonly fail to develop a high WBC count in response to several diseased states and may instead present a low WBC count. Therefore, we hypothesized that low WBC count, in addition to high WBC count, is associated with CKD progression in the elderly.

methodsWe conducted a prospective cohort study using 3-year follow-up data from the CKD Research of Outcomes in Treatment and Epidemiology study. In the present study, participants aged over 60 years with pre-dialysis CKD stages G2-G5 were eligible. Patients were stratified into three groups according to WBC count using tertiles (T). The primary outcome was a composite of end-stage renal disease and a 50% reduction in estimated glomerular filtration rate. Data were analyzed using Cox proportional hazard models with adjustments for covariates.

resultsWe enrolled 697 patients (males, 69%). The median WBC count was 6100 cells/µl (T1, <5400, n =  222; T2, 5400-6900, n =  235; T3, ≥6900, n = 240). During a median follow-up of 868 days, the primary outcome was observed in 170 patients, whereas 54 patients died. T1 and T3 had significantly higher hazard ratios (HR) than T2 (T1, HR 1.69, 95% confidence interval 1.14-2.51; T3, HR 1.63, 95% confidence interval 1.10-2.41). Moreover, T1 had a significantly higher adjusted HR (1.54, 95% confidence interval 1.00-2.37).

conclusionLow WBC count is independently associated with CKD progression in the elderly.

Indexed as

LeukocytesAgedAged, 80 and overAge FactorsDisease ProgressionFemaleGlomerular Filtration RateHumansJapanKaplan-Meier EstimateKidneyKidney Failure, ChronicLeukocyte CountLogistic ModelsMaleMiddle AgedBone marrow dysfunctionChronic kidney diseaseEnd-stage renal diseaseInflammationMalnutritionWhite blood cell count

Identifiers

PMID28699033
OpenAlexW2735226013

What OpenQuestion holds

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Registered trials

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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.