Evidence map›Paper›PMID 29728316›Full record

Observational studyAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2018

Cognitive Impairment in Non-Dialysis-Dependent CKD and the Transition to Dialysis: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.

Meera N Harhay, Dawei Xie, Xiaoming Zhang, Chi-Yuan Hsu, Eric Vittinghoff, Alan S Go, Stephen M Sozio, Jacob Blumenthal, Stephen Seliger, Jing Chen and 8 more

Open access · bronzeAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 3 pooled it
4.3field-weighted citation impact, top 5% 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

34 citing papers in PubMed, 3 syntheses or guidelines pooled it, 59 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
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  8. Care pathways for patients with cognitive impairment and chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
    Review
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  11. Observational
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  14. Review
  15. Secondary Hyperparathyroidism and Cognitive Decline.Current transplantation reports · 2023
    Article
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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

18 authors at 12 institutions in 1 country.

Meera N HarhayDivision of Nephrology and Hypertension, Drexel University College of Medicine, Philadelphia, PA. Electronic address: mnh52@drexel.edu.
Dawei XieCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Xiaoming ZhangCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Chi-Yuan HsuDivision of Nephrology, University of California, San Francisco, San Francisco, CA; Division of Research, Kaiser Permanente Northern California, Oakland, CA.
Eric VittinghoffDivision of Biostatistics, University of California, San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA.
Alan S GoDivision of Research, Kaiser Permanente Northern California, Oakland, CA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA; Department of Medicine, University of California, San Francisco, San Francisco, CA.
Stephen M SozioDivision of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD.
Jacob BlumenthalDivision of Nephrology, University of Maryland School of Medicine, Baltimore, MD.
Stephen SeligerDivision of Nephrology, University of Maryland School of Medicine, Baltimore, MD.
Jing ChenDivision of Nephrology, Department of Medicine, Tulane School of Medicine, New Orleans, LA.
Rajat DeoDivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA.
Mirela DobreDivision of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH.
Sanjeev AkkinaDepartment of Medicine, Loyola University Medical Center, Maywood, IL.
Peter P ReeseCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
James P LashDepartment of Medicine, University of Illinois at Chicago, Chicago, IL.
Kristine YaffeDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA; Department of Psychiatry, University of California, San Francisco, CA; Department of Neurology, University of California, San Francisco, CA; San Francisco VA Medical Center, San Francisco, CA.
Manjula Kurella TamuraGeriatric Research and Education Clinical Center, VA Palo Alto, Palo Alto, CA; Stanford University School of Medicine, Palo Alto, CA.
CRIC Study Investigators
University of Pennsylvania · USKaiser Permanente · USTulane University · USUniversity of California, San Francisco · USUniversity of Maryland, Baltimore · USDrexel University · USGeriatric Research Education and Clinical Center · USJohns Hopkins University · USLoyola University Medical Center · USSan Francisco VA Medical Center · USUniversity Hospitals of Cleveland · USUniversity of Illinois Chicago · US

Funding

UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
Michigan Institute for Clinical and Health Research (MICHR)UL1TR002240 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LUMENG, JULIE C, MASHOUR, GEORGE ALEXANDER · 2017 to 2022
$54.9M
Scientific and Data Coordinating Center(SDCC) for the P*U01DK060990 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI FELDMAN, HAROLD I · 2001 to 2017
$50.1M
Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
Michigan Institute for Clinical and Health Research (MCHR)UL1TR000433 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MASHOUR, GEORGE ALEXANDER · 2012 to 2016
$49.9M
Institutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9M
Clinical and Translational Science Collaborative of ClevelandUL1TR002548 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI MCCOMSEY, GRACE A · 2018 to 2022
$35.5M
Strengthening Stakeholder Engagement in Human Research Protections.UL1TR002003 · NCATS · UNIVERSITY OF ILLINOIS AT CHICAGO · PI KARNIK, NIRANJAN SUBHASH, MERMELSTEIN, ROBIN J. · 2016 to 2024
$33.7M
University of Maryland Claude D. Pepper Older Americans Independence Center (UM-OAIC)P30AG028747 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI Stephen L. Seliger · 2006 to 2026
$28.9M
Tulane COBRE in Cardiometabolic Diseases Clinical Research CoreP20GM109036 · NIGMS · TULANE UNIVERSITY OF LOUISIANA · PI Ning Liu · 2016 to 2026
$25.3M
Continuation of the Coordinating Center for the Chronic Renal Insufficiency Cohort (CRIC) StudyU24DK060990 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI Amanda Hyre Anderson, Laura M Dember · 2018 to 2026
$21.5M
Zonulin Antibodies in Intestinal Permeabilitiy in IDDMM01RR016500 · NCRR · UNIVERSITY OF MARYLAND BALTIMORE · PI ONUKWUGHA, EBERECHUKWU · 2002 to 2009
$20.2M
NCATS NIH HHS UL1 TR000424NCATS NIH HHS UL1 TR000433NCATS NIH HHS UL1 TR000439NCATS NIH HHS UL1 TR002003NCATS NIH HHS UL1 TR002240NCATS NIH HHS UL1 TR002548NCRR NIH HHS M01 RR016500NCRR NIH HHS UL1 RR024131NCRR NIH HHS UL1 RR029879NIA NIH HHS P30 AG028747NIDDK NIH HHS K23 DK105207NIDDK NIH HHS K24 DK092290NIDDK NIH HHS R01 DK069406NIDDK NIH HHS R01 DK072231NIDDK NIH HHS U01 DK060902NIDDK NIH HHS U01 DK060963NIDDK NIH HHS U01 DK060980NIDDK NIH HHS U01 DK060984NIDDK NIH HHS U01 DK060990NIDDK NIH HHS U01 DK061021NIDDK NIH HHS U01 DK061022NIDDK NIH HHS U01 DK061028NIDDK NIH HHS U24 DK060990NIGMS NIH HHS P20 GM109036
6 · The paper itself

Abstract

backgroundAdvanced chronic kidney disease is associated with elevated risk for cognitive impairment. However, it is not known whether and how cognitive impairment is associated with planning and preparation for end-stage renal disease. STUDY

designRetrospective observational study. SETTING &

participants630 adults participating in the CRIC (Chronic Renal Insufficiency Cohort) Study who had cognitive assessments in late-stage CKD, defined as estimated glome-rular filtration rate ≤ 20mL/min/1.73m PREDICTOR: Predialysis cognitive impairment, defined as a score on the Modified Mini-Mental State Examination lower than previously derived age-based threshold scores. Covariates included age, race/ethnicity, educational attainment, comorbid conditions, and health literacy. OUTCOMES: Peritoneal dialysis (PD) as first dialysis modality, preemptive permanent access placement, venous catheter avoidance at dialysis therapy initiation, and preemptive wait-listing for a kidney transplant. MEASUREMENTS: Multivariable-adjusted logistic regression.

resultsPredialysis cognitive impairment was present in 117 (19%) participants. PD was the first dialysis modality among 16% of participants (n=100), 75% had preemptive access placed (n=473), 45% avoided using a venous catheter at dialysis therapy initiation (n=279), and 20% were preemptively wait-listed (n=126). Predialysis cognitive impairment was independently associated with 78% lower odds of PD as the first dialysis modality (adjusted OR [aOR], 0.22; 95% CI, 0.06-0.74; P=0.02) and 42% lower odds of venous catheter avoidance at dialysis therapy initiation (aOR, 0.58; 95% CI, 0.34-0.98; P=0.04). Predialysis cognitive impairment was not independently associated with preemptive permanent access placement or wait-listing. LIMITATIONS: Potential unmeasured confounders; single measure of cognitive function.

conclusionsPredialysis cognitive impairment is associated with a lower likelihood of PD as a first dialysis modality and of venous catheter avoidance at dialysis therapy initiation. Future studies may consider addressing cognitive function when testing strategies to improve patient transitions to dialysis therapy.

Indexed as

AdultAgedAge FactorsCognitive Behavioral TherapyCognitive DysfunctionCohort StudiesDisease ProgressionFemaleHumansIncidenceKidney Failure, ChronicLogistic ModelsMaleMiddle AgedMultivariate AnalysisNeuropsychological Testscentral venous catheter (CVC)Chronic kidney diseases (CKDs)CKD to ESRD transitioncognitive impairmentdementiadialysis accessdialysis modalityend-stage renal disease (ESRD)executive functionincident ESRDmemoryperitoneal dialysis (PD)transplant waitlisting

Identifiers

PMID29728316
PMCPMC6153064
OpenAlexW2800774040

What OpenQuestion holds

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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.