Evidence map›Paper›PMID 28780579›Full record

ArticleHeart (British Cardiac Society)2017

A policy model of cardiovascular disease in moderate-to-advanced chronic kidney disease.

Iryna Schlackow, Seamus Kent, William Herrington, Jonathan Emberson, Richard Haynes, Christina Reith, Christoph Wanner, Bengt Fellström, Alastair Gray, Martin J Landray and 3 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Heart (British Cardiac Society), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00125593 (Study of Heart and Renal Protection), which is not on this map. Cited by 23 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 3 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.

NCT00125593 phase4completednot on this map

Study of Heart and Renal Protection (SHARP): The Effects of Lowering LDL-cholesterol With Simvastatin 20mg Plus Ezetimibe 10mg in Patients With Chronic Kidney Disease: a Randomized Placebo-controlled Trial

TypeinterventionalSponsorUniversity of OxfordRan2003 to 2010Enrolled9,438ConditionsKidney Disease, ChronicArmsSimvastatin 20 mg, Ezetimibe 10mg, Placebo
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. A Microsimulation-Based Approach for Mitigating Societal Bias in Chronic Kidney Disease Data.Medical decision making : an international journal of the Society for Medical Decision Making · 2026
    Article
  6. A microsimulation-based framework for mitigating societal bias in primary care data.medRxiv : the preprint server for health sciences · 2025
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  10. Using QALYs as an Outcome for Assessing Global Prediction Accuracy in Diabetes Simulation Models.Medical decision making : an international journal of the Society for Medical Decision Making · 2025
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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

13 authors.

Iryna SchlackowHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Seamus KentHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
William HerringtonClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Jonathan EmbersonClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Richard HaynesClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Christina ReithClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Christoph WannerDivision of Nephrology, Department of Medicine, University Hospital of Würzburg, Würzburg, Germany.
Bengt FellströmUniversity Hospital, Uppsala, Sweden.
Alastair GrayHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Martin J LandrayClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Colin BaigentClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Borislava MihaylovaHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0002-0951-1304
SHARP Collaborative Group

Funding

British Heart Foundation CH/1996001/9454Medical Research Council A310Medical Research Council MC_U137686853Medical Research Council MC_UU_12026/3Medical Research Council MC_UU_12026/5
6 · The paper itself

Abstract

objectiveTo present a long-term policy model of cardiovascular disease (CVD) in moderate-to-advanced chronic kidney disease (CKD).

methodsA Markov model with transitions between CKD stages (3B, 4, 5, on dialysis, with kidney transplant) and cardiovascular events (major atherosclerotic events, haemorrhagic stroke, vascular death) was developed with individualised CKD and CVD risks estimated using the 5 years' follow-up data of the 9270 patients with moderate-to-severe CKD in the Study of Heart and Renal Protection (SHARP) and multivariate parametric survival analysis. The model was assessed in three further CKD cohorts and compared with currently used risk scores.

resultsHigher age, previous cardiovascular events and advanced CKD were the main contributors to increased individual disease risks. CKD and CVD risks predicted by the state-transition model corresponded well to risks observed in SHARP and external cohorts. The model's predictions of vascular risk and progression to end-stage renal disease were better than, or comparable to, those produced by other risk scores. As an illustration, at age 60-69 years, projected survival for SHARP participants in CKD stage 3B was 13.5 years (10.6 quality-adjusted life years (QALYs)) in men and 14.8 years (10.7 QALYs) in women. Corresponding projections for participants on dialysis were 7.5 (5.6 QALYs) and 7.8 years (5.4 QALYs). A non-fatal major atherosclerotic event reduced life expectancy by about 2 years in stage 3B and by 1 year in dialysis.

conclusionsThe SHARP CKD-CVD model is a novel resource for evaluating health outcomes and cost-effectiveness of interventions in CKD. TRIAL REGISTRATION NUMBER: NCT00125593 and ISRCTN54137607; Post-results.

Indexed as

Decision Support TechniquesHealth Care CostsModels, EconomicPolicy MakingAdultAgedAge FactorsCardiovascular DiseasesComputer SimulationCost-Benefit AnalysisDisease ProgressionFemaleHumansKaplan-Meier EstimateMaleMarkov Chainscardiovascular riskchronic kidney diseaseCKD progressionlife expectancymarkov model

Identifiers

PMID28780579
PMCPMC5749372

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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.