Evidence map›Paper›PMID 30578152›Full record

Trial reportAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2019

Treatment of Anemia With Darbepoetin Prior to Dialysis Initiation and Clinical Outcomes: Analyses From the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT).

Finnian R Mc Causland, Brian Claggett, Emmanuel A Burdmann, Glenn M Chertow, Mark E Cooper, Kai-Uwe Eckardt, Peter Ivanovich, Andrew S Levey, Eldrin F Lewis, Janet B McGill and 8 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% 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

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Observational
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Updates on Novel Erythropoiesis-Stimulating Agents: Clinical and Molecular Approach.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2020
    Review
  13. Erythropoiesis-Stimulating Agents and Mortality.Journal of the American Society of Nephrology : JASN · 2019
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 14 institutions in 8 countries.

Finnian R Mc CauslandRenal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: fmccausland@partners.org.
Brian ClaggettHarvard Medical School, Boston, MA; Cardiology Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Emmanuel A BurdmannDivision of Nephrology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Glenn M ChertowDivision of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA.
Mark E CooperMonash University Central Clinical School, Melbourne, VIC, Australia.
Kai-Uwe EckardtDepartment of Nephrology and Hypertension, University of Erlangen-Nürnberg, Erlangen, Germany.
Peter IvanovichRenal Division, Northwestern University, Chicago, IL.
Andrew S LeveyDivision of Nephrology, Tufts Medical Center, Boston, MA.
Eldrin F LewisHarvard Medical School, Boston, MA; Cardiology Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Janet B McGillDivision of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, MO.
John J V McMurrayInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland.
Patrick ParfreyHealth Sciences Centre, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
Hans-Henrik ParvingDepartment of Medical Endocrinology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.
Giuseppe RemuzziIRCCS-Istituto di Ricerche Farmacologiche Mario Negri; Unit of Nephrology and Dialysis, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
Ajay K SinghRenal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Scott D SolomonHarvard Medical School, Boston, MA; Cardiology Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Robert D TotoRenal Division, University of Texas Southwestern, Dallas, TX.
Marc A PfefferHarvard Medical School, Boston, MA; Cardiology Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Brigham and Women's Hospital · USHarvard University · USFriedrich-Alexander-Universität Erlangen-Nürnberg · DEHealth Sciences Centre · CAMonash University · AUNorthwestern University · USRigshospitalet · DKStanford University · USThe University of Texas Southwestern Medical Center · USTufts Medical Center · USUniversidade de São Paulo · BRUniversity of Glasgow · GBUniversity of Milan · ITWashington University in St. Louis · US

Funding

Cardiac Complications of Hemodynamic Instability during HemodialysisK23DK102511 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI MCCAUSLAND, FINNIAN R · 2015 to 2019
$964k
NIDDK NIH HHS K23 DK102511
6 · The paper itself

Abstract

RATIONALE &

objectiveEvidence from clinical trials to guide patient preparation for maintenance dialysis therapy is limited. Although anemia is associated with mortality and cardiovascular (CV) disease in individuals initiating maintenance dialysis therapy, it is not known if treatment of anemia before dialysis therapy initiation with erythropoiesis-stimulating agents alters outcomes. STUDY

designPost hoc analysis of a randomized controlled trial. SETTING &

participantsParticipants with type 2 diabetes and chronic kidney disease who progressed to dialysis therapy (n=590) in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). EXPOSURE: Randomized treatment assignment (darbepoetin vs placebo). OUTCOMES: All-cause mortality, CV mortality, nonfatal myocardial infarction, heart failure, and stroke within the first 180 days of dialysis therapy initiation. ANALYTICAL APPROACH: Proportional hazards regression.

resultsOverall, 590 of 4,038 (14.6%) participants initiated dialysis therapy during the trial (n=298 and 292 in the darbepoetin and placebo groups, respectively). Corresponding hemoglobin levels were 11.3±1.6 and 9.5±1.5g/dL (P<0.001). Death from any cause occurred in 31 (10.4%) participants assigned to darbepoetin and 28 (9.6%) assigned to placebo (HR, 1.16; 95% CI, 0.69-1.93), while death from CV causes occurred in 15 (5.0%) and 13 (4.5%) participants, respectively (HR, 1.21; 95% CI, 0.58-1.93). There were no differences in risk for nonfatal myocardial infarction or heart failure. Stroke occurred in 8 (2.8%) participants assigned to darbepoetin and 1 (0.3%) assigned to placebo (HR, 8.6; 95% CI, 1.1-68.7). LIMITATIONS: Post hoc analyses of a subgroup of study participants.

conclusionsDespite initiating dialysis therapy with a higher hemoglobin level, prior treatment with darbepoetin was not associated with a reduction in mortality, myocardial infarction, or heart failure in the first 180 days, but a higher frequency of stroke was observed. In the absence of more definitive data, this may inform decisions regarding the use of erythropoiesis-stimulating agents to treat mild to moderate anemia in patients with type 2 diabetes and chronic kidney disease nearing dialysis therapy initiation.

Indexed as

Renal DialysisAgedAnemiaCardiovascular DiseasesDarbepoetin alfaDouble-Blind MethodFemaleHematinicsHumansMaleProspective StudiesRenal Insufficiency, ChronicTime FactorsTreatment OutcomeDarbepoetin alfaHematinicsAnemiacardiovascular diseasechronic kidney disease (CKD)darbepoetindeathdialysisdialysis initiationerythropoiesis stimulating agent (ESA)hemoglobin (Hb)incident dialysisstroketransition to dialysistype 2 diabetes mellitus (T2DM)

Identifiers

PMID30578152
PMCPMC6420804
OpenAlexW2905076812

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.