Evidence map›Paper›PMID 29507008›Full record

ReviewClinical journal of the American Society of Nephrology : CJASN2018

Exploring the Clinical Relevance of Providing Increased Removal of Large Middle Molecules.

Martin Wolley, Meg Jardine, Colin A Hutchison

2 registry-linked trialsAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Clinical journal of the American Society of Nephrology : CJASN, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 63 papers.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed
–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.

NCT04286477 unknown statusnot on this map

The Immune System in End Stage Chronic Kidney Disease (CKD) Patients - Comparison Among Different Modalities of Renal Replacement Therapy (RRT)

TypeobservationalSponsorUniversity of IoanninaRan2018 to 2022Enrolled45ConditionsEnd Stage Renal Disease on Dialysis
NCT04747067 nacompletednot on this mapstarted 2021, after this paper: background citation

The Effect of Hemodiafiltration Versus High Flux Dialysis On Free Light Chains Reduction And Its Relation To Albumin Loss.

TypeinterventionalSponsorAin Shams UniversityRan2021 to 2021Enrolled25ConditionsEnd Stage Renal Disease, Hemodiafiltration, HemodialysisArmsBIOPURE 260HF dialyzer
3 · Its place in the literature

Who cites it

63 citing papers in PubMed.

  1. Trial
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  4. Expanded hemodialysis as effective alternative to on-line hemodiafiltration: A randomized mid-term clinical trial.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2022
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  6. Trial
  7. Review
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  10. Effect of Hemodiafiltration and Hemodialysis on Postoperative Mortality in Patients With Kidney Failure.Hemodialysis international. International Symposium on Home Hemodialysis · 2026
    Article
  11. Review
  12. Article
  13. Article
  14. Article
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  16. Review
  17. Review
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  19. Review
  20. Article

3 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

3 authors.

Martin WolleyDepartment of Renal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Meg JardineThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Colin A HutchisonFaculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Dialysis technologies have continued to advance over recent decades; however, these advancements have not always been met with improved patient outcomes. In part, the high morbidity and mortality associated with dialysis have been attributed to a group of uremic toxins, which are described as "difficult to remove." With a new generation of hemodialysis membranes now making meaningful clearance of these molecules possible, it is an apt time to review the clinical relevance of these middle molecules. Our review describes the developments in membrane technology that enable the removal of large middle molecules (molecular mass >15 kD) that is limited with high-flux dialysis membranes. Of the known 58 middle molecules, a literature search identified 27 that have molecular mass >15 kD. This group contains cytokines, adipokines, hormones, and other proteins. These molecules are implicated in chronic inflammation, atherosclerosis, structural heart disease, and secondary immunodeficiency in the literature. Single-center safety and efficacy studies have identified that use of these membranes in maintenance dialysis populations is associated with limited loss of albumin and increased clearance of large middle molecules. Larger, robustly conducted, multicenter studies are now evaluating these findings. After completion of these safety and efficacy studies, the perceived clinical benefits of providing clearance of large middle molecules must be assessed in rigorously conducted, randomized clinical studies.

Indexed as

AtherosclerosisCardiomegalyCytokinesHumansKidney Failure, ChronicMembranes, ArtificialRenal DialysisUremiaCytokinesMembranes, ArtificialAdipokinesAlbuminsArtificialAtherosclerosiscardiovascular diseasechronic dialysisChronic inflammationcytokinesHeart Diseaseshemodialysisimmune deficiencyInflammationKidneysmalnutritionMolecular Weightrenal dialysisuremia

Identifiers

PMID29507008
PMCPMC5969479

What OpenQuestion holds

Textmetadata
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.