Evidence map›Paper›PMID 29352071›Full record

Trial reportCirculation2018

Worsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury.

Tariq Ahmad, Keyanna Jackson, Veena S Rao, W H Wilson Tang, Meredith A Brisco-Bacik, Horng H Chen, G Michael Felker, Adrian F Hernandez, Christopher M O'Connor, Venkata S Sabbisetti and 4 more

Erratum issuedOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 170 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
170citing papers in PubMed, 5 pooled it
22.2field-weighted citation impact, top 1% 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

170 citing papers in PubMed, 5 syntheses or guidelines pooled it, 337 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Ultrafiltration for acute heart failure.The Cochrane database of systematic reviews · 2022
    Pooled it
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  15. An integrated overview of acute heart failure: a narrative review of pathophysiological mechanisms and contributing factors.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026
    Review
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  18. Review
  19. Review
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110 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 8 institutions in 1 country.

Tariq AhmadSections of Cardiovascular Medicine (T.A., K.J., V.S.R., J.M.T.).
Keyanna JacksonSections of Cardiovascular Medicine (T.A., K.J., V.S.R., J.M.T.).
Veena S RaoSections of Cardiovascular Medicine (T.A., K.J., V.S.R., J.M.T.).
W H Wilson TangSection of Heart Failure and Cardiac Transplantation, The Cleveland Clinic, OH (W.H.W.T.).
Meredith A Brisco-BacikCardiology Division, Lewis Katz School of Medicine at Temple University, Philadelphia, PA (M.A.B.-B.).
Horng H ChenDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.H.C.).
G Michael FelkerDuke University Medical Center and Duke Heart Center, Durham, NC (G.M.F., A.F.H.).
Adrian F HernandezDuke University Medical Center and Duke Heart Center, Durham, NC (G.M.F., A.F.H.).
Christopher M O'ConnorInova Heart and Vascular Institute, Falls Church, VA (C.M.O.).
Venkata S SabbisettiDivision of Renal Medicine, Brigham and Women's Hospital, Boston, MA (V.S.S., J.V.B.).
Joseph V BonventreDivision of Renal Medicine, Brigham and Women's Hospital, Boston, MA (V.S.S., J.V.B.).
F Perry WilsonNephrology (F.P.W.), Yale University School of Medicine, New Haven, CT.
Steven G CocaDivision of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY (S.G.C.).
Jeffrey M TestaniSections of Cardiovascular Medicine (T.A., K.J., V.S.R., J.M.T.) jeffrey.testani@yale.edu.
Brigham and Women's Hospital · USDuke Medical Center · USAlaska Heart and Vascular Institute · USCleveland Clinic · USIcahn School of Medicine at Mount Sinai · USMayo Clinic · USTemple University · USYale University · US

Funding

Renal Physiology and Phenotyping CoreP30DK079310 · NIDDK · YALE UNIVERSITY · PI ISHIBE, SHUTA · 2008 to 2022
$16.8M
KIDNEY INJURY MOLECULE-1 IN EPITHELIAL REPAIRR01DK072381 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI BONVENTRE, JOSEPH VINCENT · 2005 to 2025
$8.6M
Optimizing Electronic Alerts for Acute Kidney InjuryR01DK113191 · NIDDK · YALE UNIVERSITY · PI WILSON, FRANCIS PERRY · 2018 to 2022
$3.1M
Mediators & prognostic value of muscle mass & function in chronic kidney diseaseK23DK097201 · NIDDK · YALE UNIVERSITY · PI WILSON, FRANCIS PERRY · 2013 to 2017
$916k
Cardio-renal phenotype and prognosis in chronic heart failureK23HL114868 · NHLBI · YALE UNIVERSITY · PI TESTANI, JEFFREY M · 2012 to 2017
$845k
Determining Mechanisms of Renal Dysfunction after Left Ventricular Assist DeviceK23HL128933 · NHLBI · TEMPLE UNIV OF THE COMMONWEALTH · PI BRISCO-BACIK, MEREDITH ANN · 2015 to 2019
$831k
NHLBI NIH HHS K23 HL114868NHLBI NIH HHS K23 HL128933NHLBI NIH HHS L30 HL115790NIDDK NIH HHS K23 DK097201NIDDK NIH HHS P30 DK079310NIDDK NIH HHS R01 DK072381NIDDK NIH HHS R01 DK113191
6 · The paper itself

Abstract

backgroundWorsening renal function (WRF) in the setting of aggressive diuresis for acute heart failure treatment may reflect renal tubular injury or simply indicate a hemodynamic or functional change in glomerular filtration. Well-validated tubular injury biomarkers,

methodsPatients in the multicenter ROSE-AHF trial with baseline and 72-hour urine tubular injury biomarkers were analyzed (n=283). WRF was defined as a ≥20% decrease in glomerular filtration rate estimated with cystatin C.

resultsConsistent with protocol-driven aggressive dosing of loop diuretics, participants received a median 560 mg IV furosemide equivalents (interquartile range, 300-815 mg), which induced a urine output of 8425 mL (interquartile range, 6341-10 528 mL) over the 72-hour intervention period. Levels of

conclusionsKidney tubular injury does not appear to have an association with WRF in the context of aggressive diuresis of patients with acute heart failure. These findings reinforce the notion that the small to moderate deteriorations in renal function commonly encountered with aggressive diuresis are dissimilar from traditional causes of acute kidney injury.

Indexed as

AcetylglucosaminidaseAcute DiseaseAcute Kidney InjuryAgedAged, 80 and overBiomarkersCreatinineCystatin CDiuresisFemaleGlomerular Filtration RateHeart FailureHepatitis A Virus Cellular Receptor 1HumansKidneyLipocalin-2AcetylglucosaminidaseBiomarkersCreatinineCST3 protein, humanCystatin CHAVCR1 protein, humanHepatitis A Virus Cellular Receptor 1LCN2 protein, humanLipocalin-2Sodium Potassium Chloride Symporter Inhibitorsacute kidney injurybiomarkersheart failurerenal insufficiency

Identifiers

PMID29352071
PMCPMC6066176
OpenAlexW2784257687

What OpenQuestion holds

Textmetadata
LicenceTDM
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.